Metabolic bone: hyperparathyroidism: 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: hyperparathyroidism

Sample item

Which radiographic finding of the hand is the most characteristic early sign of hyperparathyroidism?

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

The answer and the reasoning

B. Subperiosteal resorption on the radial side of the middle phalanges

Subperiosteal bone resorption, most marked on the radial border of the middle phalanges of the index and middle fingers, is pathognomonic of hyperparathyroidism. Late changes include brown tumours, salt-and-pepper skull and osteitis fibrosa cystica.

Option by option

  • A. Soap-bubble lesion in the epiphysis

    A soap-bubble lesion suggests giant cell tumour, which histologically resembles a brown tumour.

  • B. Subperiosteal resorption on the radial side of the middle phalanges (correct)

    Correct. Radial-sided subperiosteal resorption is the classic sign.

  • C. Erlenmeyer flask deformity

    Erlenmeyer flask deformity occurs in osteopetrosis and Gaucher disease.

  • D. Sclerosis of the phalangeal tufts

    Acro-osteolysis occurs in hyperparathyroidism, rather than tuft sclerosis.

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 B, Subperiosteal resorption on the radial side of the middle phalanges. Subperiosteal bone resorption, most marked on the radial border of the middle phalanges of the index and middle fingers, is pathognomonic of hyperparathyroidism.

Why is "Soap-bubble lesion in the epiphysis" not the answer?

A soap-bubble lesion suggests giant cell tumour, which histologically resembles a brown tumour.

Why is "Erlenmeyer flask deformity" not the answer?

Erlenmeyer flask deformity occurs in osteopetrosis and Gaucher disease.

Why is "Sclerosis of the phalangeal tufts" not the answer?

Acro-osteolysis occurs in hyperparathyroidism, rather than tuft sclerosis.

What concept does this question test?

It tests Metabolic bone: hyperparathyroidism in Orthopaedics. Late changes include brown tumours, salt-and-pepper skull and osteitis fibrosa cystica.

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: hyperparathyroidism?

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.