Abdominal imaging: appendicitis: 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 · Abdominal imaging: appendicitis

Sample item

A 12-year-old girl has right iliac fossa pain. Which ultrasound finding supports acute appendicitis?

AA normal-looking terminal ileumBA non-compressible, blind-ending tubular structure larger than 6 mm with surrounding echogenic fatCFree fluid in the pouch of Douglas aloneDA compressible appendix of 4 mm that contains gas

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

The answer and the reasoning

B. A non-compressible, blind-ending tubular structure larger than 6 mm with surrounding echogenic fat

In acute appendicitis, graded compression ultrasound shows a non-compressible, aperistaltic, blind-ending tube with an outer diameter above 6 mm, often with an appendicolith, periappendiceal fluid and hyperechoic inflamed fat. Ultrasound is the first-line test in children and pregnant women to avoid radiation. CT is used when ultrasound is non-diagnostic in adults.

Option by option

A. A normal-looking terminal ileum
A normal ileum does not support appendicitis.
B. A non-compressible, blind-ending tubular structure larger than 6 mm with surrounding echogenic fat (correct)
Correct. These features indicate an inflamed appendix.
C. Free fluid in the pouch of Douglas alone
Free fluid alone is non-specific.
D. A compressible appendix of 4 mm that contains gas
A compressible small appendix with gas is normal.

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.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, A non-compressible, blind-ending tubular structure larger than 6 mm with surrounding echogenic fat. In acute appendicitis, graded compression ultrasound shows a non-compressible, aperistaltic, blind-ending tube with an outer diameter above 6 mm, often with an appendicolith, periappendiceal fluid and hyperechoic inflamed fat.

Why is "A normal-looking terminal ileum" not the answer?

A normal ileum does not support appendicitis.

Why is "Free fluid in the pouch of Douglas alone" not the answer?

Free fluid alone is non-specific.

Why is "A compressible appendix of 4 mm that contains gas" not the answer?

A compressible small appendix with gas is normal.

What concept does this question test?

It tests Abdominal imaging: appendicitis in Radiology. Ultrasound is the first-line test in children and pregnant women to avoid radiation. CT is used when ultrasound is non-diagnostic in adults.

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 Abdominal imaging: appendicitis?

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.