Spine imaging: tethered cord: 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: tethered cord

Sample item

A child with a sacral dimple and a hairy patch has urinary urgency and foot deformity. MRI shows the conus medullaris ending at L4 with a thickened filum terminale. What is the diagnosis?

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

The answer and the reasoning

D. Tethered cord syndrome

The conus normally lies at or above L2-L3 after infancy, and a low-lying conus with a thick filum (over 2 mm) indicates a tethered cord. Surgical untethering prevents progressive neurological deficits.

Option by option

  • A. Spinal epidural abscess

    An abscess is an enhancing collection with fever.

  • B. Normal anatomy for age

    The adult conus level is about L1-L2, not L4.

  • C. Syringomyelia

    Syringomyelia is a cavity within the cord.

  • D. Tethered cord syndrome (correct)

    Correct. A low conus with a thick filum is tethered cord.

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 D, Tethered cord syndrome. The conus normally lies at or above L2-L3 after infancy, and a low-lying conus with a thick filum (over 2 mm) indicates a tethered cord.

Why is "Spinal epidural abscess" not the answer?

An abscess is an enhancing collection with fever.

Why is "Normal anatomy for age" not the answer?

The adult conus level is about L1-L2, not L4.

Why is "Syringomyelia" not the answer?

Syringomyelia is a cavity within the cord.

What concept does this question test?

It tests Spine imaging: tethered cord in Radiology. Surgical untethering prevents progressive neurological deficits.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: tethered cord?

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.