Question

Pseudofractures are seen in

• A. Osteomalacia
• B. Multiple myeloma
• C. Osteoporosis
• D. Skeletal metastasis

Hint:

Think about which bone disease involves a mineralization defect rather than just bone loss.

Answer 1

The Correct Option is A

Step 1: Understanding the Question:
The question asks about pseudofractures, a specific radiological finding, and which metabolic bone disease it points to.

Step 2: Key Concept or Approach:
Pseudofractures, also called Looser's zones or Milkman's lines, are radiolucent bands running perpendicular to the bone cortex, seen at sites of mechanical stress such as the pubic rami, femoral neck, scapula and ribs. They represent unmineralized osteoid laid down along stress lines that never calcified because of a defect in mineralization.

Step 3: Working Through the Options:
Osteomalacia is the adult counterpart of rickets, a defect in mineralizing newly formed bone matrix, usually from vitamin D deficiency, renal tubular disorders or chronic kidney disease. The unmineralized osteoid at stress points shows up as these lucent bands, the pseudofractures. Multiple myeloma instead produces punched-out lytic lesions from plasma cell infiltration, a different picture. Osteoporosis is a quantitative loss of bone mass with normal mineralization, causing compression fractures and cortical thinning rather than Looser's zones. Skeletal metastasis produces lytic, sclerotic or mixed lesions depending on the primary tumor, again without the classic pseudofracture pattern.

Step 4: Conclusion:
Pseudofractures are a hallmark finding of osteomalacia, so osteomalacia is correct.