Musculoskeletal 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 · Musculoskeletal imaging: pyogenic spondylodiscitis

Sample item

A diabetic man has fever and severe back pain. Which finding is earliest on the plain radiograph in pyogenic vertebral osteomyelitis?

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

The answer and the reasoning

B. Narrowing of the disc space with endplate erosion

Pyogenic infection spreads from the subchondral endplate into the disc early, so disc space narrowing with blurred and eroded endplates appears first. MRI is more sensitive and shows endplate oedema and disc hyperintensity.

Option by option

  • A. Paravertebral calcified abscess

    A calcified paravertebral abscess is a feature of tuberculous spondylitis.

  • B. Narrowing of the disc space with endplate erosion (correct)

    Correct. Early disc involvement gives disc space narrowing with endplate erosion in pyogenic infection.

  • C. Gibbus deformity with kyphosis

    Gibbus deformity follows advanced vertebral collapse, usually in tuberculosis.

  • D. Anterior flowing ossification of the spine

    Anterior flowing ossification is seen in diffuse idiopathic skeletal hyperostosis.

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 B, Narrowing of the disc space with endplate erosion. Pyogenic infection spreads from the subchondral endplate into the disc early, so disc space narrowing with blurred and eroded endplates appears first.

Why is "Paravertebral calcified abscess" not the answer?

A calcified paravertebral abscess is a feature of tuberculous spondylitis.

Why is "Gibbus deformity with kyphosis" not the answer?

Gibbus deformity follows advanced vertebral collapse, usually in tuberculosis.

Why is "Anterior flowing ossification of the spine" not the answer?

Anterior flowing ossification is seen in diffuse idiopathic skeletal hyperostosis.

What concept does this question test?

It tests Musculoskeletal imaging: pyogenic spondylodiscitis in Radiology. MRI is more sensitive and shows endplate oedema and disc hyperintensity.

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 Musculoskeletal 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.