MSK imaging: non-accidental injury: 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 · MSK imaging: non-accidental injury

Sample item

A 6-month-old infant has unexplained irritability. A skeletal survey shows metaphyseal 'corner' or 'bucket-handle' fractures and multiple posterior rib fractures. What is the most likely cause?

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

The answer and the reasoning

C. Non-accidental injury (child abuse)

Metaphyseal corner fractures from shaking or twisting forces and posterior rib fractures from squeezing are highly specific for abuse. Fractures of different ages, skull fractures and subdural haematomas further support the diagnosis. A skeletal survey and CT or MRI head are needed, with child protection referral.

Option by option

  • A. Osteopetrosis

    Osteopetrosis shows dense bones and brittle fractures of simple type.

  • B. Normal infant variation

    These findings are not normal variations.

  • C. Non-accidental injury (child abuse) (correct)

    Correct. Corner fractures and posterior rib fractures are highly specific for abuse.

  • D. Rickets

    Rickets shows cupping and fraying rather than fractures.

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 Radiology question

What is the answer to this Radiology question?

The best answer is C, Non-accidental injury (child abuse). Metaphyseal corner fractures from shaking or twisting forces and posterior rib fractures from squeezing are highly specific for abuse.

Why is "Osteopetrosis" not the answer?

Osteopetrosis shows dense bones and brittle fractures of simple type.

Why is "Normal infant variation" not the answer?

These findings are not normal variations.

Why is "Rickets" not the answer?

Rickets shows cupping and fraying rather than fractures.

What concept does this question test?

It tests MSK imaging: non-accidental injury in Radiology. Fractures of different ages, skull fractures and subdural haematomas further support the diagnosis. A skeletal survey and CT or MRI head are needed, with child protection referral.

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 MSK imaging: non-accidental injury?

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.