MSK imaging: Looser zones: 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: Looser zones

Sample item

A radiograph of a woman with vitamin D deficiency shows bilateral symmetrical linear lucent bands perpendicular to the cortex in the pubic rami and femoral necks. What are these?

AStress fractures of athletesBBrown tumoursCLooser zones (pseudofractures) of osteomalaciaDNutrient canals

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

The answer and the reasoning

C. Looser zones (pseudofractures) of osteomalacia

Looser zones are insufficiency fractures through unmineralised osteoid, typically symmetrical and perpendicular to the cortex in pubic rami, femoral necks, scapulae and ribs. They are pathognomonic of osteomalacia. Treatment is with vitamin D and calcium.

Option by option

A. Stress fractures of athletes
Stress fractures are asymmetric and related to activity.
B. Brown tumours
Brown tumours are lytic lesions of hyperparathyroidism.
C. Looser zones (pseudofractures) of osteomalacia (correct)
Correct. Symmetrical pseudofractures indicate osteomalacia.
D. Nutrient canals
Nutrient canals are normal lucent lines in cortex that do not cross it.

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.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Looser zones (pseudofractures) of osteomalacia. Looser zones are insufficiency fractures through unmineralised osteoid, typically symmetrical and perpendicular to the cortex in pubic rami, femoral necks, scapulae and ribs.

Why is "Stress fractures of athletes" not the answer?

Stress fractures are asymmetric and related to activity.

Why is "Brown tumours" not the answer?

Brown tumours are lytic lesions of hyperparathyroidism.

Why is "Nutrient canals" not the answer?

Nutrient canals are normal lucent lines in cortex that do not cross it.

What concept does this question test?

It tests MSK imaging: Looser zones in Radiology. They are pathognomonic of osteomalacia. Treatment is with vitamin D and calcium.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: Looser zones?

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.