Musculoskeletal Imaging MCQs

Radiology · 5 free questions with answers & explanations.

1. A 25-year-old male athlete presents with lateral knee pain after a twisting injury. MRI of the knee shows a vertical tear extending from the meniscal body to the superior surface, with a displaced fragment lying parallel to the posterior cruciate ligament within the intercondylar notch. What type of meniscal tear is this?
2. A 16-year-old boy presents with pain around the right knee. Plain radiograph shows an aggressive-looking lesion in the distal femoral metaphysis with a permeative lytic pattern, cortical destruction, and a periosteal reaction showing multiple layers of new bone formation concentric to the cortex (onion-skin periostitis). No calcified matrix is visible. What is the most likely diagnosis?
3. A 55-year-old postmenopausal woman with known osteoporosis is investigated for back pain. On MRI of the lumbar spine, a vertebral compression fracture at L2 shows low signal intensity on T1, high signal on STIR/fat-suppressed T2, restricted diffusion on DWI, and convex posterior cortex bulging. What feature most reliably distinguishes this as a pathological (malignant) rather than an osteoporotic fracture?
4. A 35-year-old woman presents with wrist pain and swelling. Radiographs show periarticular osteopenia, uniform joint space narrowing of the radiocarpal and intercarpal joints bilaterally, and erosions at the ulnar styloid process. What is the most likely underlying diagnosis?
5. A 30-year-old professional footballer sustains an acute knee injury during a tackle. MRI shows bone contusions in the lateral femoral condyle and posterior lateral tibial plateau with a characteristic kissing pattern. There is also complete disruption of the anterior cruciate ligament fibres with the ligament lying horizontally. What additional MRI finding confirms the associated pivot shift mechanism?