Musculoskeletal imaging: vertebral haemangioma: 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: vertebral haemangioma

Sample item

A CT of the lumbar spine in a 50-year-old shows an L2 vertebral body with coarse vertical trabeculae that appear as small dots on axial images, and the lesion is bright on both T1 and T2 MRI. Which diagnosis is most likely?

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

The answer and the reasoning

C. Vertebral haemangioma

Vertebral haemangioma contains fat and vascular channels between thickened vertical trabeculae, giving a corduroy appearance on radiographs and a polka-dot pattern on axial CT. The fat makes it bright on T1 and T2, and it is usually incidental.

Option by option

  • A. Osteoblastic metastasis

    An osteoblastic metastasis is dense and low in signal, without fat signal or a polka-dot pattern.

  • B. Paget disease of the vertebra

    Paget disease enlarges the vertebra with cortical thickening, giving a picture-frame appearance.

  • C. Vertebral haemangioma (correct)

    Correct. Thickened vertical trabeculae with a polka-dot pattern and fat signal on MRI are characteristic of a haemangioma.

  • D. Multiple myeloma

    Multiple myeloma produces punched-out lytic lesions, not coarse vertical trabeculae with fat signal.

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 C, Vertebral haemangioma. Vertebral haemangioma contains fat and vascular channels between thickened vertical trabeculae, giving a corduroy appearance on radiographs and a polka-dot pattern on axial CT.

Why is "Osteoblastic metastasis" not the answer?

An osteoblastic metastasis is dense and low in signal, without fat signal or a polka-dot pattern.

Why is "Paget disease of the vertebra" not the answer?

Paget disease enlarges the vertebra with cortical thickening, giving a picture-frame appearance.

Why is "Multiple myeloma" not the answer?

Multiple myeloma produces punched-out lytic lesions, not coarse vertical trabeculae with fat signal.

What concept does this question test?

It tests Musculoskeletal imaging: vertebral haemangioma in Radiology. The fat makes it bright on T1 and T2, and it is usually incidental.

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: vertebral haemangioma?

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.