Musculoskeletal imaging: osteogenesis imperfecta: 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: osteogenesis imperfecta

Sample item

An infant has repeated fractures after minimal handling and blue sclerae. A skull radiograph shows multiple small ossicles within the sutures and generalised osteopenia with thin cortices. What is the most likely diagnosis?

ANon-accidental injuryBScurvyCRicketsDOsteogenesis imperfecta

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

The answer and the reasoning

D. Osteogenesis imperfecta

Osteogenesis imperfecta is a collagen type I disorder with brittle bones, blue sclerae and wormian bones in the skull sutures. Blue sclerae and generalised osteopenia help separate it from non-accidental injury.

Option by option

A. Non-accidental injury
Non-accidental injury produces fractures of varying ages, such as corner fractures and posterior rib fractures, without blue sclerae or wormian bones.
B. Scurvy
Scurvy shows a white line of Frankel and a Wimberger ring, with subperiosteal haemorrhage.
C. Rickets
Rickets shows metaphyseal cupping and fraying with a widened growth plate.
D. Osteogenesis imperfecta (correct)
Correct. Fractures with minimal trauma, blue sclerae, osteopenia and wormian bones indicate osteogenesis imperfecta.

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.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Osteogenesis imperfecta. Osteogenesis imperfecta is a collagen type I disorder with brittle bones, blue sclerae and wormian bones in the skull sutures.

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

Non-accidental injury produces fractures of varying ages, such as corner fractures and posterior rib fractures, without blue sclerae or wormian bones.

Why is "Scurvy" not the answer?

Scurvy shows a white line of Frankel and a Wimberger ring, with subperiosteal haemorrhage.

Why is "Rickets" not the answer?

Rickets shows metaphyseal cupping and fraying with a widened growth plate.

What concept does this question test?

It tests Musculoskeletal imaging: osteogenesis imperfecta in Radiology. Blue sclerae and generalised osteopenia help separate it from non-accidental injury.

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: osteogenesis imperfecta?

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.