Earliest X-Ray finding in Osteomyelitis:

Ans. (d) Periosteal reactionRef. Maheshwari 8th ed. /169; Harrison's 18th cd. Ch 126* Earliest X-Ray change: Loss of soft tissue plane which is seen after 24 hours. In case of osteomyelitis X-Ray is normal during first 24 hours.* 2nd X-Ray change seen in periosteal reaction, which is usually seen 7-10 days after infection.* Periosteal reaction can be of 3 types:# No reaction: seen in case of TB# Narrow zone of activity: Benign condition (Ex: in infection like osteomyelitis)# Wide zone of activity: Malignant condition (Ex: Codmans triangle in osteosarcoma)