MSK imaging: multiple myeloma: 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: multiple myeloma

Sample item

A 65-year-old has bone pain, anaemia and hypercalcaemia. A skull radiograph shows multiple well-defined 'punched-out' lytic lesions without sclerotic margins. What is the diagnosis?

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

The answer and the reasoning

B. Multiple myeloma

Myeloma produces multiple sharply defined lytic lesions (raindrop skull), as osteoblastic activity is suppressed, so bone scans may be normal. Whole-body low-dose CT or MRI is used for staging. Paget disease shows cotton wool patches.

Option by option

  • A. Paget disease

    Paget disease shows mixed sclerosis and coarse trabeculae.

  • B. Multiple myeloma (correct)

    Correct. Punched-out lytic lesions without a sclerotic rim suggest myeloma.

  • C. Osteoblastic metastases

    Osteoblastic metastases are dense lesions.

  • D. Fibrous dysplasia

    Fibrous dysplasia shows ground glass lesions.

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 B, Multiple myeloma. Myeloma produces multiple sharply defined lytic lesions (raindrop skull), as osteoblastic activity is suppressed, so bone scans may be normal.

Why is "Paget disease" not the answer?

Paget disease shows mixed sclerosis and coarse trabeculae.

Why is "Osteoblastic metastases" not the answer?

Osteoblastic metastases are dense lesions.

Why is "Fibrous dysplasia" not the answer?

Fibrous dysplasia shows ground glass lesions.

What concept does this question test?

It tests MSK imaging: multiple myeloma in Radiology. Whole-body low-dose CT or MRI is used for staging. Paget disease shows cotton wool patches.

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: multiple myeloma?

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.