Spine: inverted supinator sign: 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: inverted supinator sign

Sample item

A patient has clumsy hands. When the examiner taps the brachioradialis tendon the fingers flex instead of the elbow flexing and the forearm supinating. What does this suggest?

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

The answer and the reasoning

D. Cord compression at the C5-C6 level with a root lesion

The inverted supinator sign means the brachioradialis reflex arc (C5-C6) is interrupted while the segments below are hyperreflexic, so finger flexion occurs on tapping. It localises cervical myelopathy with a lesion at C5-C6. It is often found with Hoffmann sign and spasticity.

Option by option

  • A. Carpal tunnel syndrome

    Carpal tunnel syndrome does not alter the brachioradialis reflex.

  • B. Lumbar canal stenosis

    Lumbar stenosis affects the lower limbs.

  • C. Peripheral neuropathy at the wrist

    A peripheral wrist neuropathy does not produce brisk reflexes.

  • D. Cord compression at the C5-C6 level with a root lesion (correct)

    Correct. It localises cord compression with a root lesion at C5-C6.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Cord compression at the C5-C6 level with a root lesion. The inverted supinator sign means the brachioradialis reflex arc (C5-C6) is interrupted while the segments below are hyperreflexic, so finger flexion occurs on tapping.

Why is "Carpal tunnel syndrome" not the answer?

Carpal tunnel syndrome does not alter the brachioradialis reflex.

Why is "Lumbar canal stenosis" not the answer?

Lumbar stenosis affects the lower limbs.

Why is "Peripheral neuropathy at the wrist" not the answer?

A peripheral wrist neuropathy does not produce brisk reflexes.

What concept does this question test?

It tests Spine: inverted supinator sign in Orthopaedics. It localises cervical myelopathy with a lesion at C5-C6. It is often found with Hoffmann sign and spasticity.

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: inverted supinator sign?

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.