MRONJ — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRheumatologyMRONJRACP Adult Medicine

A 70-year-old woman with a history of osteoporosis on zoledronic acid develops jaw pain and exposed bone in the mandible 6 months after a dental extraction. What is the diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Medication-related osteonecrosis of the jaw (MRONJ)

MRONJ (medication-related osteonecrosis of the jaw) is characterised by exposed bone in the oral cavity persisting for >8 weeks in patients on antiresorptive (bisphosphonates, denosumab) or antiangiogenic therapy, with no history of radiation. Dental extraction is the most common precipitant. Risk is much higher with IV bisphosphonates for cancer (1–10%) than oral bisphosphonates for osteoporosis (<0.1%). Prevention includes dental assessment BEFORE starting therapy and maintenance of good oral hygiene.

Reference: eTG – 2025 – Rheumatology; RACDS – 2024 – MRONJ Position Statement