Metabolic bone: renal osteodystrophy: 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: renal osteodystrophy

Sample item

A patient on long-term dialysis has a lateral spine radiograph showing dense sclerotic bands at the vertebral endplates alternating with a lucent central zone. What is this appearance called?

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

The answer and the reasoning

C. Rugger jersey spine

Rugger jersey spine, with horizontal bands of subchondral sclerosis at the endplates, is a feature of renal osteodystrophy due to secondary hyperparathyroidism. Bamboo spine is a feature of ankylosing spondylitis, and picture-frame vertebra is a feature of Paget disease.

Option by option

  • A. Picture frame vertebra

    A picture frame vertebra is seen in Paget disease.

  • B. Bone-within-bone appearance

    Bone-within-bone appearance is seen in osteopetrosis.

  • C. Rugger jersey spine (correct)

    Correct. Alternating sclerotic bands give rugger jersey spine.

  • D. Bamboo spine

    Bamboo spine reflects syndesmophytes in ankylosing spondylitis.

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, Rugger jersey spine. Rugger jersey spine, with horizontal bands of subchondral sclerosis at the endplates, is a feature of renal osteodystrophy due to secondary hyperparathyroidism.

Why is "Picture frame vertebra" not the answer?

A picture frame vertebra is seen in Paget disease.

Why is "Bone-within-bone appearance" not the answer?

Bone-within-bone appearance is seen in osteopetrosis.

Why is "Bamboo spine" not the answer?

Bamboo spine reflects syndesmophytes in ankylosing spondylitis.

What concept does this question test?

It tests Metabolic bone: renal osteodystrophy in Orthopaedics. Bamboo spine is a feature of ankylosing spondylitis, and picture-frame vertebra is a feature of Paget disease.

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: renal osteodystrophy?

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.