Spine: imaging when MRI is contraindicated: practice question

A Orthopaedics 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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Orthopaedics · Spine: imaging when MRI is contraindicated

Sample item

A 70-year-old with an old non-MRI-compatible pacemaker has leg pain and suspected lumbar canal stenosis. Which imaging is an appropriate alternative to MRI?

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

The answer and the reasoning

A. CT myelography

MRI is the investigation of choice for discs, cord and nerve roots, but it may be contraindicated by some implanted devices. CT with intrathecal contrast outlines the thecal sac and nerve roots and also shows bone detail. Plain films and bone scans do not show neural compression.

Option by option

  • A. CT myelography (correct)

    Correct. CT myelography shows neural compression when MRI cannot be used.

  • B. Plain radiographs only

    Plain films show bone alignment but not the nerves.

  • C. Ultrasound of the spine

    Ultrasound cannot image the adult lumbar canal.

  • D. Isotope bone scan

    A bone scan shows increased turnover and not neural compression.

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.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, CT myelography. MRI is the investigation of choice for discs, cord and nerve roots, but it may be contraindicated by some implanted devices.

Why is "Plain radiographs only" not the answer?

Plain films show bone alignment but not the nerves.

Why is "Ultrasound of the spine" not the answer?

Ultrasound cannot image the adult lumbar canal.

Why is "Isotope bone scan" not the answer?

A bone scan shows increased turnover and not neural compression.

What concept does this question test?

It tests Spine: imaging when MRI is contraindicated in Orthopaedics. CT with intrathecal contrast outlines the thecal sac and nerve roots and also shows bone detail. Plain films and bone scans do not show neural compression.

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 when MRI is contraindicated?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.