Ossification, Skeletal Maturation and Radiographic Anatomy MCQs

Anatomy · 24 free questions with answers & explanations.

1. The epiphysis of the femoral head appears on radiograph at approximately 4–6 months of age. In Perthes disease (avascular necrosis of femoral head in children), the earliest radiographic sign is:
2. For forensic age estimation of an individual between 16–25 years, the most reliable ossification centre to assess is:
3. The elbow joint has a specific sequence of ossification centre appearance remembered by the mnemonic CRITOE. In which order do the following centres appear: capitellum (C), radial head (R), internal (medial) epicondyle (I), trochlea (T), olecranon (O), external (lateral) epicondyle (E)?
4. In a 3-year-old child, which epiphyseal centre SHOULD be present around the elbow on a plain X-ray according to the CRITOE sequence?
5. An 18-year-old male presents for age estimation. Radiograph of the medial clavicle shows that the epiphysis is beginning to fuse but is not completely united. This finding is consistent with which age range?
6. Which carpal bone is the LAST to ossify, and its delayed or absent ossification is associated with Kienböck's disease?
7. Which is the LAST epiphysis to fuse in the upper limb, and at what approximate age?
8. On a lateral radiograph of the elbow in a child, the ossification centers appear in which sequence?
9. The order of appearance of secondary ossification centres around the elbow can be remembered by the mnemonic CRITOE. What does the 'O' in CRITOE represent, and at what approximate age does it appear?
10. Wormian (sutural) bones are most characteristically associated with which skeletal dysplasia?
11. On a radiograph of the hand used for bone age assessment (Greulich-Pyle method), fusion of the growth plate of the distal radius indicates skeletal maturity at approximately:
12. The carrying angle of the elbow is formed by the relationship between the long axis of the humerus and the forearm in full extension and supination. An exaggerated carrying angle (cubitus valgus) after a childhood lateral condyle fracture most dangerously injures which nerve?
13. The ossification centre for the medial epicondyle of the humerus appears at approximately age 5–7 years. In the mnemonic CRITOE, the order of appearance is: Capitellum (1 yr), Radial head (3 yr), Internal (medial) epicondyle (5 yr), Trochlea (7 yr), Olecranon (9 yr), External (lateral) epicondyle (11 yr). Which injury pattern requires knowledge of this sequence?
14. In skeletal age estimation using the hand-wrist radiograph (Greulich and Pyle atlas), fusion of which epiphysis indicates that skeletal maturity is essentially complete?
15. A radiograph of the elbow in a child shows 5 ossification centers appearing. The mnemonic CRITOE describes the sequence of appearance. Which center appears last in this sequence?
16. In forensic age estimation, fusion of the medial clavicular epiphysis (sternal end) occurs last among long bone epiphyses. This fusion is completed at which age range, making it valuable for differentiating legal age boundaries?
17. Regarding the ossification of the femur, which statement correctly describes both primary and secondary ossification centers?
18. The secondary ossification center for the lateral epicondyle of the humerus appears and fuses at approximately which age (mnemonic: CRITOE sequence)?
19. In medicolegal age estimation, the iliac crest apophysis fusion (Risser sign) is widely used. Risser grade 4 indicates:
20. The elbow joint has six ossification centers that appear in a predictable sequence. What mnemonic describes the order of their appearance, and which center appears LAST?
21. A 7-year-old child sustains an elbow injury. On X-ray, which epiphyseal ossification center is expected to be present in the elbow at this age?
22. The clavicle is unique among long bones because its ossification is predominantly:
23. In assessing skeletal maturity of the hand-wrist for bone age estimation (Greulich and Pyle atlas), which bone is considered to be the most reliable indicator of puberty-associated growth acceleration?
24. The lower end of the femur has an epiphyseal ossification center that is present from birth and is used as a medicolegal indicator of: