Retroperitoneal imaging: retroperitoneal fibrosis: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Retroperitoneal imaging: retroperitoneal fibrosis

Sample item

A middle-aged man with back pain and raised ESR has bilateral hydronephrosis. CT shows a soft tissue plaque around the abdominal aorta at L4-L5 that medially displaces the ureters. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Retroperitoneal fibrosis

Chronic periaortitis forms a fibrous mass that encases the aorta and ureters, causing ureteric obstruction with medial deviation. It is often idiopathic or related to IgG4 disease.

Option by option

  • A. Retroperitoneal fibrosis (correct)

    Correct. A periaortic plaque with medial ureters and hydronephrosis fits retroperitoneal fibrosis.

  • B. Lymphoma of the kidney

    Renal lymphoma causes masses or infiltration within the kidney.

  • C. Horseshoe kidney

    A horseshoe kidney has fused lower poles and doesn't cause this plaque.

  • D. Abdominal aortic aneurysm rupture

    A ruptured aneurysm shows acute haematoma and an aortic defect.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Retroperitoneal fibrosis. Chronic periaortitis forms a fibrous mass that encases the aorta and ureters, causing ureteric obstruction with medial deviation.

Why is "Lymphoma of the kidney" not the answer?

Renal lymphoma causes masses or infiltration within the kidney.

Why is "Horseshoe kidney" not the answer?

A horseshoe kidney has fused lower poles and doesn't cause this plaque.

Why is "Abdominal aortic aneurysm rupture" not the answer?

A ruptured aneurysm shows acute haematoma and an aortic defect.

What concept does this question test?

It tests Retroperitoneal imaging: retroperitoneal fibrosis in Radiology. It is often idiopathic or related to IgG4 disease.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Retroperitoneal imaging: retroperitoneal fibrosis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.