Metabolic bone: osteomalacia: practice question

A Orthopaedics 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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Orthopaedics · Metabolic bone: osteomalacia

Sample item

A woman with chronic malabsorption has diffuse bone pain, proximal weakness and waddling gait. Radiographs show bilateral symmetrical linear lucencies perpendicular to the cortex in the femoral neck and pubic rami. What are these?

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

The answer and the reasoning

C. Looser zones (Milkman pseudofractures)

Looser zones are pseudofractures, unmineralised osteoid seams at sites of arterial pulsation or stress, characteristic of osteomalacia. They are bilateral and symmetrical, and treatment is vitamin D with calcium and correction of the cause.

Option by option

  • A. Brown tumours

    Brown tumours are seen in hyperparathyroidism.

  • B. Pencil-in-cup deformities

    Pencil-in-cup deformity is seen in psoriatic arthritis.

  • C. Looser zones (Milkman pseudofractures) (correct)

    Correct. Looser zones are the hallmark of osteomalacia.

  • D. Codman triangles

    Codman triangles are seen in aggressive bone tumours.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Looser zones (Milkman pseudofractures). Looser zones are pseudofractures, unmineralised osteoid seams at sites of arterial pulsation or stress, characteristic of osteomalacia.

Why is "Brown tumours" not the answer?

Brown tumours are seen in hyperparathyroidism.

Why is "Pencil-in-cup deformities" not the answer?

Pencil-in-cup deformity is seen in psoriatic arthritis.

Why is "Codman triangles" not the answer?

Codman triangles are seen in aggressive bone tumours.

What concept does this question test?

It tests Metabolic bone: osteomalacia in Orthopaedics. They are bilateral and symmetrical, and treatment is vitamin D with calcium and correction of the cause.

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 Metabolic bone: osteomalacia?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.