MSK imaging: osteopetrosis: 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: osteopetrosis

Sample item

A child with anaemia and hepatosplenomegaly has radiographs showing uniformly dense bones with a 'bone within bone' appearance, and sclerotic bands at the vertebral endplates. What is the diagnosis?

AOsteopetrosisBRicketsCScurvyDAchondroplasia

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

The answer and the reasoning

A. Osteopetrosis

Defective osteoclast function causes failure of bone resorption, so bones are dense but brittle. Rugger-jersey spine (sclerotic endplates with a lucent central part) and bone-in-bone appearance are classic, and marrow failure leads to anaemia and extramedullary haematopoiesis. Bone marrow transplantation can be curative in infantile cases.

Option by option

A. Osteopetrosis (correct)
Correct. Dense bones with a bone-within-bone appearance is osteopetrosis.
B. Rickets
Rickets shows widened, cupped metaphyses with poor mineralisation.
C. Scurvy
Scurvy shows a ground-glass osteopenia with a dense metaphyseal line.
D. Achondroplasia
Achondroplasia shows short limbs and a champagne glass pelvis.

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 A, Osteopetrosis. Defective osteoclast function causes failure of bone resorption, so bones are dense but brittle.

Why is "Rickets" not the answer?

Rickets shows widened, cupped metaphyses with poor mineralisation.

Why is "Scurvy" not the answer?

Scurvy shows a ground-glass osteopenia with a dense metaphyseal line.

Why is "Achondroplasia" not the answer?

Achondroplasia shows short limbs and a champagne glass pelvis.

What concept does this question test?

It tests MSK imaging: osteopetrosis in Radiology. Rugger-jersey spine (sclerotic endplates with a lucent central part) and bone-in-bone appearance are classic, and marrow failure leads to anaemia and extramedullary haematopoiesis. Bone marrow transplantation can be curative in infantile cases.

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: osteopetrosis?

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.