MSK imaging: Ewing sarcoma: 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: Ewing sarcoma

Sample item

A 10-year-old child has fever, pain and a raised ESR. A radiograph of the femoral diaphysis shows a permeative lytic lesion with a lamellated (onion-skin) periosteal reaction. What is the likely diagnosis?

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

The answer and the reasoning

A. Ewing sarcoma

Ewing sarcoma arises in the diaphysis of long bones and flat bones, with a permeative pattern and onion-skin reaction, and may mimic osteomyelitis. It carries the t(11;22) translocation. It is radiosensitive.

Option by option

  • A. Ewing sarcoma (correct)

    Correct. A diaphyseal permeative lesion with onion-skin reaction suggests Ewing sarcoma.

  • B. Osteosarcoma

    Osteosarcoma is metaphyseal and produces bone matrix.

  • C. Giant cell tumour

    Giant cell tumour occurs in the epiphysis of skeletally mature patients.

  • D. Osteoid osteoma

    Osteoid osteoma is a small nidus with surrounding 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.

More Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Ewing sarcoma. Ewing sarcoma arises in the diaphysis of long bones and flat bones, with a permeative pattern and onion-skin reaction, and may mimic osteomyelitis.

Why is "Osteosarcoma" not the answer?

Osteosarcoma is metaphyseal and produces bone matrix.

Why is "Giant cell tumour" not the answer?

Giant cell tumour occurs in the epiphysis of skeletally mature patients.

Why is "Osteoid osteoma" not the answer?

Osteoid osteoma is a small nidus with surrounding sclerosis.

What concept does this question test?

It tests MSK imaging: Ewing sarcoma in Radiology. It carries the t(11;22) translocation. It is radiosensitive.

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: Ewing sarcoma?

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.