MSK imaging: Langerhans cell histiocytosis of the spine: 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 · MSK imaging: Langerhans cell histiocytosis of the spine

Sample item

A 5-year-old child has back pain. A lateral spine radiograph shows a thin, flattened, dense vertebral body with preserved disc spaces. What is this called and the likely cause?

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

The answer and the reasoning

B. Vertebra plana from Langerhans cell histiocytosis

Eosinophilic granuloma of the vertebral body collapses it to a thin disc, but the disc spaces are spared and the posterior elements are intact. In children, this is the classical cause of vertebra plana.

Option by option

  • A. Scheuermann disease

    Scheuermann disease shows wedging of several vertebrae and Schmorl nodes in adolescents.

  • B. Vertebra plana from Langerhans cell histiocytosis (correct)

    Correct. A flattened vertebra with normal discs in a child suggests LCH.

  • C. Pott disease

    Pott disease destroys the disc and adjacent vertebrae with a paravertebral abscess.

  • D. Osteoporotic fracture

    Osteoporosis is unusual in a young child.

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 B, Vertebra plana from Langerhans cell histiocytosis. Eosinophilic granuloma of the vertebral body collapses it to a thin disc, but the disc spaces are spared and the posterior elements are intact.

Why is "Scheuermann disease" not the answer?

Scheuermann disease shows wedging of several vertebrae and Schmorl nodes in adolescents.

Why is "Pott disease" not the answer?

Pott disease destroys the disc and adjacent vertebrae with a paravertebral abscess.

Why is "Osteoporotic fracture" not the answer?

Osteoporosis is unusual in a young child.

What concept does this question test?

It tests MSK imaging: Langerhans cell histiocytosis of the spine in Radiology. In children, this is the classical cause of vertebra plana.

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 MSK imaging: Langerhans cell histiocytosis of the spine?

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.