Bone and joint infections: osteomyelitis: practice question

A Orthopaedics 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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Orthopaedics · Bone and joint infections: osteomyelitis

Sample item

A 9-year-old with fever and a painful distal femur for four days has an essentially normal radiograph apart from swelling. When does a periosteal reaction typically become visible on plain films in acute osteomyelitis?

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

The answer and the reasoning

B. After about 10 to 14 days

Plain radiographs lag behind disease, and bone changes such as periosteal reaction appear after 10 to 14 days. In early cases, MRI or a bone scan is used, and treatment should not wait for X-ray changes.

Option by option

  • A. Within the first 24 hours

    The first day shows at most soft tissue swelling, not bone change.

  • B. After about 10 to 14 days (correct)

    Correct. Periosteal elevation shows after roughly 10 to 14 days.

  • C. After about 6 months

    Six months is far too late and would be a delayed or chronic stage.

  • D. Only after sequestrum formation at 3 months

    A sequestrum is a late finding of chronic osteomyelitis, long after periosteal reaction.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, After about 10 to 14 days. Plain radiographs lag behind disease, and bone changes such as periosteal reaction appear after 10 to 14 days.

Why is "Within the first 24 hours" not the answer?

The first day shows at most soft tissue swelling, not bone change.

Why is "After about 6 months" not the answer?

Six months is far too late and would be a delayed or chronic stage.

Why is "Only after sequestrum formation at 3 months" not the answer?

A sequestrum is a late finding of chronic osteomyelitis, long after periosteal reaction.

What concept does this question test?

It tests Bone and joint infections: osteomyelitis in Orthopaedics. In early cases, MRI or a bone scan is used, and treatment should not wait for X-ray changes.

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 Bone and joint infections: osteomyelitis?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.