Nuclear medicine: bone scan: 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 · Nuclear medicine: bone scan

Sample item

A bone scan with Tc-99m methylene diphosphonate shows multiple focal areas of increased uptake in the spine and ribs in a patient with prostate cancer. What does this represent?

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

The answer and the reasoning

A. Osteoblastic metastases

Tc-99m MDP localises where osteoblastic activity and blood flow are increased, so sclerotic metastases of prostate cancer show hot spots, often in an axial distribution. Purely lytic lesions, as in myeloma, may appear cold. A superscan shows diffuse increased bone uptake with poor renal and soft tissue activity.

Option by option

  • A. Osteoblastic metastases (correct)

    Correct. Multiple hot spots indicate osteoblastic metastases.

  • B. Multiple myeloma only

    Myeloma often shows normal or cold areas on bone scan.

  • C. Normal variant

    Multiple focal axial lesions are not normal.

  • D. Cold lesions from purely lytic disease

    Hot, not cold, spots are described.

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.

More Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Osteoblastic metastases. Tc-99m MDP localises where osteoblastic activity and blood flow are increased, so sclerotic metastases of prostate cancer show hot spots, often in an axial distribution.

Why is "Multiple myeloma only" not the answer?

Myeloma often shows normal or cold areas on bone scan.

Why is "Normal variant" not the answer?

Multiple focal axial lesions are not normal.

Why is "Cold lesions from purely lytic disease" not the answer?

Hot, not cold, spots are described.

What concept does this question test?

It tests Nuclear medicine: bone scan in Radiology. Purely lytic lesions, as in myeloma, may appear cold. A superscan shows diffuse increased bone uptake with poor renal and soft tissue activity.

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 Nuclear medicine: bone scan?

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.