Spine imaging: tuberculous spondylitis: 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 · Spine imaging: tuberculous spondylitis

Sample item

A patient with back pain, low-grade fever and a gibbus deformity has MRI showing destruction of two adjacent vertebral bodies, preservation of the disc until late and a paravertebral abscess. What is the diagnosis?

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

The answer and the reasoning

A. Pott spine (tuberculous spondylitis)

Tuberculosis involves the anterior vertebral bodies adjacent to the disc, and spreads under the anterior longitudinal ligament, with relative sparing of the disc until later and large paraspinal abscesses with calcification. Pyogenic infection destroys the disc early. Metastases spare the disc and show pedicle involvement.

Option by option

  • A. Pott spine (tuberculous spondylitis) (correct)

    Correct. Vertebral destruction with disc sparing and paravertebral abscess suggests Pott spine.

  • B. Metastatic disease

    Metastases usually spare the disc and involve the pedicle.

  • C. Pyogenic discitis

    Pyogenic infection involves the disc early with endplate erosion.

  • D. Ankylosing spondylitis

    Ankylosing spondylitis gives a bamboo spine.

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 A, Pott spine (tuberculous spondylitis). Tuberculosis involves the anterior vertebral bodies adjacent to the disc, and spreads under the anterior longitudinal ligament, with relative sparing of the disc until later and large paraspinal abscesses with calcification.

Why is "Metastatic disease" not the answer?

Metastases usually spare the disc and involve the pedicle.

Why is "Pyogenic discitis" not the answer?

Pyogenic infection involves the disc early with endplate erosion.

Why is "Ankylosing spondylitis" not the answer?

Ankylosing spondylitis gives a bamboo spine.

What concept does this question test?

It tests Spine imaging: tuberculous spondylitis in Radiology. Pyogenic infection destroys the disc early. Metastases spare the disc and show pedicle involvement.

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 imaging: tuberculous spondylitis?

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.