MSK imaging: osteomyelitis: 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: osteomyelitis

Sample item

A child with fever and a painful swollen knee has normal initial radiographs. Which investigation is the most sensitive for early acute osteomyelitis?

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

The answer and the reasoning

C. MRI

Plain film changes of osteomyelitis (periosteal reaction, lucency) take 10 to 14 days to appear. MRI shows marrow oedema and abscess within 1 to 2 days with high sensitivity. Bone scan is an alternative if MRI is unavailable.

Option by option

  • A. Ultrasound of the muscle

    Ultrasound can show subperiosteal collection but is less sensitive for marrow.

  • B. Repeat plain radiograph after 24 hours

    Radiographs remain normal for about 10 to 14 days.

  • C. MRI (correct)

    Correct. MRI is the most sensitive early test.

  • D. DEXA scan

    DEXA is for bone density.

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, MRI. Plain film changes of osteomyelitis (periosteal reaction, lucency) take 10 to 14 days to appear.

Why is "Ultrasound of the muscle" not the answer?

Ultrasound can show subperiosteal collection but is less sensitive for marrow.

Why is "Repeat plain radiograph after 24 hours" not the answer?

Radiographs remain normal for about 10 to 14 days.

Why is "DEXA scan" not the answer?

DEXA is for bone density.

What concept does this question test?

It tests MSK imaging: osteomyelitis in Radiology. MRI shows marrow oedema and abscess within 1 to 2 days with high sensitivity. Bone scan is an alternative if MRI is unavailable.

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: osteomyelitis?

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.