MSK imaging: pyogenic spondylodiscitis: 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: pyogenic spondylodiscitis

Sample item

A diabetic man has fever and severe back pain. MRI shows T2 hyperintense disc, endplate erosion and marrow oedema in two adjacent vertebrae, with an enhancing paravertebral collection. What is the diagnosis?

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

The answer and the reasoning

D. Pyogenic spondylodiscitis

Infection typically starts at the endplate, spreads to the disc and neighbouring vertebra, so that the disc is bright on T2 and destroyed with paravertebral or epidural collections. Metastases usually spare the disc.

Option by option

  • A. Metastatic disease

    Metastases spare the disc and rarely cross it.

  • B. Degenerative Modic change

    Modic changes do not form enhancing collections.

  • C. Ankylosing spondylitis

    Ankylosing spondylitis shows syndesmophytes and sacroiliitis.

  • D. Pyogenic spondylodiscitis (correct)

    Correct. Disc involvement with adjacent endplate destruction and collection is infective.

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, Pyogenic spondylodiscitis. Infection typically starts at the endplate, spreads to the disc and neighbouring vertebra, so that the disc is bright on T2 and destroyed with paravertebral or epidural collections.

Why is "Metastatic disease" not the answer?

Metastases spare the disc and rarely cross it.

Why is "Degenerative Modic change" not the answer?

Modic changes do not form enhancing collections.

Why is "Ankylosing spondylitis" not the answer?

Ankylosing spondylitis shows syndesmophytes and sacroiliitis.

What concept does this question test?

It tests MSK imaging: pyogenic spondylodiscitis in Radiology. Metastases usually spare the disc.

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 MSK imaging: pyogenic spondylodiscitis?

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.