Spine: SCIWORA: 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.

Try it

Orthopaedics · Spine: SCIWORA

Sample item

A 5-year-old falls from a swing and has transient numbness of both arms, followed by weakness. Plain films and CT show no fracture or malalignment, and MRI shows cord oedema. What is this condition?

ATransient brachial plexus neurapraxiaBSCIWORA from paediatric spinal elasticityCAtlantoaxial rotatory subluxationDConversion disorder

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

The answer and the reasoning

B. SCIWORA from paediatric spinal elasticity

Children have a more elastic and mobile spine than the cord, so a stretching force can injure the cord with no bony injury. This spinal cord injury without radiographic abnormality is investigated with MRI and managed by immobilisation and supportive care.

Option by option

A. Transient brachial plexus neurapraxia
A plexus neurapraxia affects one arm and does not cause cord oedema.
B. SCIWORA from paediatric spinal elasticity (correct)
Correct. Cord injury with normal bony imaging in a young child is typical of SCIWORA.
C. Atlantoaxial rotatory subluxation
Rotatory subluxation gives a fixed head tilt and shows abnormal alignment on CT.
D. Conversion disorder
Conversion disorder would not produce objective cord oedema on MRI.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, SCIWORA from paediatric spinal elasticity. Children have a more elastic and mobile spine than the cord, so a stretching force can injure the cord with no bony injury.

Why is "Transient brachial plexus neurapraxia" not the answer?

A plexus neurapraxia affects one arm and does not cause cord oedema.

Why is "Atlantoaxial rotatory subluxation" not the answer?

Rotatory subluxation gives a fixed head tilt and shows abnormal alignment on CT.

Why is "Conversion disorder" not the answer?

Conversion disorder would not produce objective cord oedema on MRI.

What concept does this question test?

It tests Spine: SCIWORA in Orthopaedics. This spinal cord injury without radiographic abnormality is investigated with MRI and managed by immobilisation and supportive care.

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: SCIWORA?

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.