Head and neck imaging: orbital imaging: 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 · Head and neck imaging: orbital imaging

Sample item

Which finding on CT or MRI of the orbit is characteristic of thyroid eye disease?

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

The answer and the reasoning

D. Enlarged extraocular muscle bellies with sparing of the tendons

In Graves orbitopathy the muscle bellies are enlarged and the tendinous insertions are spared, in contrast to orbital pseudotumour in which tendons are involved. The inferior and medial recti are most often affected. Compressive optic neuropathy occurs at the orbital apex.

Option by option

  • A. Intraconal cavernous haemangioma

    A haemangioma is a discrete lesion.

  • B. Optic nerve sheath thickening only

    Optic nerve sheath thickening suggests meningioma or optic neuritis.

  • C. Enlarged muscle tendons and bellies

    Tendon involvement suggests an inflammatory pseudotumour.

  • D. Enlarged extraocular muscle bellies with sparing of the tendons (correct)

    Correct. Muscle belly enlargement with tendon sparing is typical.

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 D, Enlarged extraocular muscle bellies with sparing of the tendons. In Graves orbitopathy the muscle bellies are enlarged and the tendinous insertions are spared, in contrast to orbital pseudotumour in which tendons are involved.

Why is "Intraconal cavernous haemangioma" not the answer?

A haemangioma is a discrete lesion.

Why is "Optic nerve sheath thickening only" not the answer?

Optic nerve sheath thickening suggests meningioma or optic neuritis.

Why is "Enlarged muscle tendons and bellies" not the answer?

Tendon involvement suggests an inflammatory pseudotumour.

What concept does this question test?

It tests Head and neck imaging: orbital imaging in Radiology. The inferior and medial recti are most often affected. Compressive optic neuropathy occurs at the orbital apex.

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 Head and neck imaging: orbital imaging?

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.