Spine: epidural abscess: 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: epidural abscess

Sample item

An intravenous drug user has back pain, fever, and new leg weakness. Which investigation is the best next step?

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

The answer and the reasoning

C. Urgent MRI of the whole spine with contrast

The classic triad of spinal epidural abscess is back pain, fever and neurological deficit. MRI with gadolinium is the investigation of choice and should be done urgently, along with blood cultures, and treatment is surgical decompression and antibiotics for Staphylococcus aureus.

Option by option

  • A. Plain radiographs and a review in 2 weeks

    Plain films are insensitive and delaying risks permanent paralysis.

  • B. Lumbar puncture before imaging

    Lumbar puncture through an abscess risks spreading infection.

  • C. Urgent MRI of the whole spine with contrast (correct)

    Correct. Urgent MRI is the best investigation.

  • D. Bone scan after 1 week

    A bone scan is slow and less specific.

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, Urgent MRI of the whole spine with contrast. The classic triad of spinal epidural abscess is back pain, fever and neurological deficit.

Why is "Plain radiographs and a review in 2 weeks" not the answer?

Plain films are insensitive and delaying risks permanent paralysis.

Why is "Lumbar puncture before imaging" not the answer?

Lumbar puncture through an abscess risks spreading infection.

Why is "Bone scan after 1 week" not the answer?

A bone scan is slow and less specific.

What concept does this question test?

It tests Spine: epidural abscess in Orthopaedics. MRI with gadolinium is the investigation of choice and should be done urgently, along with blood cultures, and treatment is surgical decompression and antibiotics for Staphylococcus aureus.

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: epidural abscess?

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.