Spine: lumbar canal stenosis: 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: lumbar canal stenosis

Sample item

A 68-year-old man has leg pain and heaviness on walking, relieved by sitting or leaning forward, with normal pedal pulses. What is the likely diagnosis?

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

The answer and the reasoning

C. Neurogenic claudication from lumbar canal stenosis

Lumbar spinal stenosis causes neurogenic claudication, in which extension narrows the canal and aggravates symptoms, and flexion by sitting or leaning forward (shopping trolley sign) relieves them. Peripheral pulses are normal, and MRI confirms the diagnosis.

Option by option

  • A. Peripheral neuropathy

    Neuropathy gives constant sensory symptoms, not walking-related claudication.

  • B. Vascular claudication

    Vascular claudication is relieved by standing still and shows absent pulses.

  • C. Neurogenic claudication from lumbar canal stenosis (correct)

    Correct. Relief by flexion with normal pulses suggests neurogenic claudication.

  • D. Hip osteoarthritis

    Hip osteoarthritis causes groin pain and stiffness.

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 C, Neurogenic claudication from lumbar canal stenosis. Lumbar spinal stenosis causes neurogenic claudication, in which extension narrows the canal and aggravates symptoms, and flexion by sitting or leaning forward (shopping trolley sign) relieves them.

Why is "Peripheral neuropathy" not the answer?

Neuropathy gives constant sensory symptoms, not walking-related claudication.

Why is "Vascular claudication" not the answer?

Vascular claudication is relieved by standing still and shows absent pulses.

Why is "Hip osteoarthritis" not the answer?

Hip osteoarthritis causes groin pain and stiffness.

What concept does this question test?

It tests Spine: lumbar canal stenosis in Orthopaedics. Peripheral pulses are normal, and MRI confirms the diagnosis.

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: lumbar canal stenosis?

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.