Käme eventuell auch eine Osteonekrose in Betracht?

This sentence was used in the context of providing an alternative diagnosis for bone changes seen on MRI.

I looked up in Betracht and found in Betracht kommen, which makes sense as you would want to consider Osteonekrose as a possibility to explain the signal change.

However why have they used käme? I understand on a technical level that it is the Konjunktiv II form of kommen, but it’d be helpful to understand (with some examples if possible) the reason for this usage.

For example, in day to day speech, if doctors were conveying this to each other over the phone, would they actually use käme or could they have said the following?

Osteonekrose wäre auch in Betracht gekommen.

(I’m not actually sure if my alternative sentence with wäre is correct, but for my current level of German, it conveys for me a sense of diagnostic uncertainty with wäre.)

  • 1
    Just a quick comment on the last bit - "kommen" is a verb of motion, and its perfect tenses are formed using "sein", not "haben". So: "Osteonekrose wäre auch in Betracht gekommen." Commented Oct 9, 2014 at 11:10

4 Answers 4


There is nothing in this sentence that requires the use of the subjunctive.

Kommt auch eine Osteonekrose in Betracht?

is a correct sentence with the same meaning.

However, since the question implicitly suggests that whoever is asked has overlooked or wrongly excluded the possibility of an osteonecrosis, I would often use a Konjunktiv II of politeness here. It may help understanding this to regard this as an irrealis which maximally attenuates the factuality of my suggestion beforehand, i.e., I state that an osteonecrosis actually does not need to be considered – but that’s really only an approach to understand the subjunctive of politeness.

In particular, I would not use the subjunctive here, if I am not talking to somebody who is responsible for making diagnosis. For example, if I were talking with somebody about a medical check he received, I could ask:

Halten die Ärzte eine Osteonekrose für möglich?

But in this context, it would be grammatically wrong to ask:

Hielten die Ärzte eine Osteonekrose für möglich?
(Do the doctors consider an osteonecrosis?)

Compare to the following sentences which also differ only in this politeness aspect (and are both correct):

Kannst Du mir das Salz reichen?
Könntest Du mir das Salz reichen?
(Could you pass me the salt?)

Haben sie gerade eine Minute Zeit für mich?
Hätten sie gerade eine Minute Zeit für mich?
(Do you have a minute for me? – Can I take one minute of your time?)

Ich brauche einen Laib Brot.
Ich bräuchte einen Laib Brot.
(I need a loaf of bread.)

Note that though this is often claimed, the Konjunktiv does not express possibilities in modern German (except for some fossilised expressions) but only happens to be often used for something that is possible. In the above examples for the subjunctive of politeness, the variant without the Konjunktiv does not imply any different factuality of what is said. This is implied by the context (with or without Konjunktiv).

If this sentence weren’t a queston, i.e., if a doctor reports to another that an osteonecrosis is considered, it would be:

Eine Osteonekrose kommt auch in Betracht.

Using the Konjunktiv II here would imply that it does not actually need to be considered for some reason.

Eine Osteonekrose käme auch in Betracht. Aber die Blutwerte sprechen dagegen.
(An osteonecrosis would need to be considered, if it weren’t for the result of the blood test.)


As rogermue correctly pointed out, Konjunktiv II is used to express a possibility.

The fragment presented in the question is either a question or part of a statement. (It is not a stand-alone statement because the verb needs to be in the second place of the sentence in a statement.)


Käme eventuell auch eine Osteonekrose in Betracht?

Statement, e.g.:

Wenn weitere Fakten gegen die erste Diagnose sprächen, käme eventuell auch eine Osteonekrose in Betracht.

Translating "in Betracht kommen" with "to be considered" [1], the literal translation of the question is:

Would possibly also an osteonecrosis be considered?

The translation becomes more pointed when translating "in Betracht kommen" with "to be possible":

Would possibly also an osteonecrosis be possible?

The question is very tentative, osteonecrosis is presented as a remote possibility. A possible reason could be that the asker is trying not to affront the person who stated the first explanation for the bone changes seen on the MRI.

The Indicative form of the question is:

Kommt auch eine Osteonekrose in Betracht?

Is an ostenecrosis also (being) considered?

Is also an ostenecrosis possible?

This is also correct usage, but less tentative. (There is still some tentative-ness in the phrase "In Betracht kommen" itself.)

For the statement form, similar considerations apply. It could also be less tentatively put in the Indicative case.

Concerning the usage question: It is not uncommon for people, especially university graduates, to use this phrase when talking on the phone. The more colloquial form of Konjunktiv II is with "würden":

Würde eine Osteonekrose auch in Betracht kommen?

[1] http://dict.leo.org/?lp=ende&search=in+betracht+kommen


The sentence is a good example of how we can introduce several levels of uncertainty in a statement.

The doctor who wrote this managed to include 5 of them:

  1. Es ist eine Osteonekrose.
  2. Es ist eventuell eine Osteonekrose.
  3. Eine Osteonekrose kommt eventuell in Betracht.
  4. Auch eine Osteonekrose kommt eventuell in Betracht.
  5. Auch eine Osteonekrose käme eventuell in Betracht.

Subjunctive mood in 5. is one of many means to express a possibility (hence the German name Möglichkeitsform) or uncertainty.

Now all these were topped by putting it into a question which would transfer all responsibility to the one answering:

  1. Käme eventuell auch eine Osteonekrose in Betracht?
  • 1
    I disagree with the subjunctive expressing possibilities in German (see Belles Lettres on this). If the subjunctive would actually have the function of expressing a possibility, you could add a level of uncertainty by going from “Es ist eine Osteonekrose” to “Es wäre eine Osteonekrose”. Even your number 5 is not a valid sentence unless you imply some unfulfilled (irreal) condition.
    – Wrzlprmft
    Commented Oct 9, 2014 at 15:16
  • @Wrzlprmft: ich habe den Satz ja so nicht geschrieben, und würde ihn so auch nicht schreiben. In dem konkreten Beispiel benutzt der Autor den Konjunktiv aber vermutlich schon als "Möglichkeitsform" (es sei denn, es käme noch ein Nebensatz, von dem wir nichts wissen). "Eventuell" ist m.E. hier der Weg zur irrealen Annahme.
    – Takkat
    Commented Oct 9, 2014 at 18:06

By "käme in Betracht" (past subjunctive) a remote possibility is expressed, meaning "something might be possible".

  • I agree that the subjunctive is used to express a possiblity. But I would consider 'käme in Betracht' present subjunctive. Past subjunctive would be 'wäre in Betracht gekommen'.
    – Georg
    Commented Oct 9, 2014 at 8:26
  • Present subjunktive is "komme".
    – rogermue
    Commented Oct 9, 2014 at 9:24
  • And this is why past subjunctive or Konjunktiv Präteritum is a bad name for Konjunktiv II.
    – Wrzlprmft
    Commented Oct 9, 2014 at 9:32
  • I don't use Konjunktive I or II, I don't like these terms that are used only in German Grammars, but not in English or French ones. I use the same terms for all languages I can handle, simply because it is unpractical to change terms from one language to another.
    – rogermue
    Commented Oct 9, 2014 at 9:40

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