MSK imaging: hyperparathyroidism: 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: hyperparathyroidism

Sample item

A patient with recurrent renal stones and hypercalcaemia has hand radiographs showing subperiosteal resorption along the radial aspect of the middle phalanges. What is the diagnosis?

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

The answer and the reasoning

C. Hyperparathyroidism

Subperiosteal bone resorption on the radial side of the middle phalanges of the index and middle fingers is a pathognomonic sign of hyperparathyroidism. Other signs are salt-and-pepper skull, brown tumours and acro-osteolysis. Rugger jersey spine appears in renal osteodystrophy.

Option by option

  • A. Rickets

    Rickets shows physeal widening.

  • B. Hypoparathyroidism

    Hypoparathyroidism shows basal ganglia calcification and dense bones.

  • C. Hyperparathyroidism (correct)

    Correct. Radial-side subperiosteal resorption is the pathognomonic sign.

  • D. Acromegaly

    Acromegaly shows spade-like terminal phalanges and heel pad thickening.

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, Hyperparathyroidism. Subperiosteal bone resorption on the radial side of the middle phalanges of the index and middle fingers is a pathognomonic sign of hyperparathyroidism.

Why is "Rickets" not the answer?

Rickets shows physeal widening.

Why is "Hypoparathyroidism" not the answer?

Hypoparathyroidism shows basal ganglia calcification and dense bones.

Why is "Acromegaly" not the answer?

Acromegaly shows spade-like terminal phalanges and heel pad thickening.

What concept does this question test?

It tests MSK imaging: hyperparathyroidism in Radiology. Other signs are salt-and-pepper skull, brown tumours and acro-osteolysis. Rugger jersey spine appears in renal osteodystrophy.

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: hyperparathyroidism?

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.