Musculoskeletal imaging: local staging of osteosarcoma: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Musculoskeletal imaging: local staging of osteosarcoma

Sample item

A 16-year-old has a biopsy-proven osteosarcoma of the distal femur. Which imaging best defines intramedullary extent and skip lesions before surgery?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. MRI of the entire affected bone including the adjacent joint

MRI shows marrow involvement, soft-tissue extension, relation to neurovascular structures and skip lesions, and the whole bone should be imaged. Chest CT is also needed to look for pulmonary metastases.

Option by option

  • A. Repeat plain radiograph with oblique views

    Repeat radiographs show the cortex but not marrow extent or skip lesions.

  • B. CT of the thigh alone

    CT of the thigh alone is inferior for marrow and soft-tissue extent and would miss skip lesions outside the field.

  • C. Ultrasound of the thigh

    Ultrasound cannot evaluate marrow extent or deep structures reliably.

  • D. MRI of the entire affected bone including the adjacent joint (correct)

    Correct. MRI of the entire bone and adjacent joint best shows marrow extent and skip lesions.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, MRI of the entire affected bone including the adjacent joint. MRI shows marrow involvement, soft-tissue extension, relation to neurovascular structures and skip lesions, and the whole bone should be imaged.

Why is "Repeat plain radiograph with oblique views" not the answer?

Repeat radiographs show the cortex but not marrow extent or skip lesions.

Why is "CT of the thigh alone" not the answer?

CT of the thigh alone is inferior for marrow and soft-tissue extent and would miss skip lesions outside the field.

Why is "Ultrasound of the thigh" not the answer?

Ultrasound cannot evaluate marrow extent or deep structures reliably.

What concept does this question test?

It tests Musculoskeletal imaging: local staging of osteosarcoma in Radiology. Chest CT is also needed to look for pulmonary metastases.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Musculoskeletal imaging: local staging of osteosarcoma?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.