Spine imaging: Chance fracture: 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 · Spine imaging: Chance fracture

Sample item

A restrained passenger in a head-on collision has back pain. Lateral spine film shows a horizontal fracture through the vertebral body, pedicles and spinous process of L1 with widened posterior elements. What is this injury and the associated risk?

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

The answer and the reasoning

C. Chance (flexion-distraction) fracture with associated intra-abdominal injury

A lap seat belt acts as a fulcrum, producing flexion-distraction injury that splits the vertebra horizontally. It is commonly accompanied by bowel and mesenteric injury, so CT of the abdomen is needed.

Option by option

  • A. Hangman fracture

    A hangman fracture involves the pars of C2.

  • B. Jefferson fracture

    A Jefferson fracture involves the ring of C1.

  • C. Chance (flexion-distraction) fracture with associated intra-abdominal injury (correct)

    Correct. A horizontal split through all three columns is a Chance fracture.

  • D. Burst fracture from axial load

    A burst fracture is caused by axial load with retropulsion.

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 C, Chance (flexion-distraction) fracture with associated intra-abdominal injury. A lap seat belt acts as a fulcrum, producing flexion-distraction injury that splits the vertebra horizontally.

Why is "Hangman fracture" not the answer?

A hangman fracture involves the pars of C2.

Why is "Jefferson fracture" not the answer?

A Jefferson fracture involves the ring of C1.

Why is "Burst fracture from axial load" not the answer?

A burst fracture is caused by axial load with retropulsion.

What concept does this question test?

It tests Spine imaging: Chance fracture in Radiology. It is commonly accompanied by bowel and mesenteric injury, so CT of the abdomen is needed.

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 Spine imaging: Chance fracture?

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.