Musculoskeletal imaging: infantile cortical hyperostosis: 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: infantile cortical hyperostosis

Sample item

A 3-month-old irritable infant has fever and firm swelling of the jaw. Radiographs show thick layers of periosteal new bone along the mandible, clavicle and ulna. What is the diagnosis?

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

The answer and the reasoning

A. Infantile cortical hyperostosis (Caffey disease)

Caffey disease presents before 5 months of age with irritability, fever and soft-tissue swelling, with exuberant periosteal new bone most often in the mandible, clavicle and ulna. It is self-limiting.

Option by option

  • A. Infantile cortical hyperostosis (Caffey disease) (correct)

    Correct. Early infantile fever with mandibular swelling and diffuse cortical thickening is Caffey disease.

  • B. Scurvy

    Scurvy occurs after about 6 months, with metaphyseal changes and subperiosteal haemorrhage.

  • C. Acute osteomyelitis

    Acute osteomyelitis is usually solitary, with a destructive metaphyseal focus, not symmetrical multifocal hyperostosis.

  • D. Non-accidental injury

    Non-accidental injury produces fractures at different stages of healing, such as metaphyseal corner fractures and rib fractures.

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 A, Infantile cortical hyperostosis (Caffey disease). Caffey disease presents before 5 months of age with irritability, fever and soft-tissue swelling, with exuberant periosteal new bone most often in the mandible, clavicle and ulna.

Why is "Scurvy" not the answer?

Scurvy occurs after about 6 months, with metaphyseal changes and subperiosteal haemorrhage.

Why is "Acute osteomyelitis" not the answer?

Acute osteomyelitis is usually solitary, with a destructive metaphyseal focus, not symmetrical multifocal hyperostosis.

Why is "Non-accidental injury" not the answer?

Non-accidental injury produces fractures at different stages of healing, such as metaphyseal corner fractures and rib fractures.

What concept does this question test?

It tests Musculoskeletal imaging: infantile cortical hyperostosis in Radiology. It is self-limiting.

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: infantile cortical hyperostosis?

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.