Differential Diagnosis by Location or Radiographic Finding—Spine

Question 1

Atlantoaxial subluxation in rheumatoid arthritis is due to which of the following?
● A. Erosion of insertion points of the TAL
● B. Congenital laxity of the TAL
● C. Disruption (tear) of the TAL
● D. Avulsion of the insertion points of the TAL
● E. Incompetence of the odontoid process

Answer 1

A. Erosion of insertion points of the TAL

Question 2

Fractures due to metastatic involvement show which of the following?
● A. Hyperintense on T1WI and hyperintense on T2WI
● B. Hypointense on T1WI and hyperintense on T2WI
● C. Isointense on T1WI and hypointense on T2WI
● D. Hypointense on T1WI and hypointense on T2WI
● E. Hyperintense on T1WI and hypointense on T2WI

Answer 2

B. Hypointense on T1WI and hyperintense on T2WI

Question 3

Criteria for vertebra plana include all of the following except?
● A. Increased density of vertebra
● B. Spares neural arches
● C. Normal disk and intervertebral disk space
● D. Intervertebral vacuum cleft sign
● E. Kyphosis

Answer 3

E. Kyphosis

Question 4

Destruction of the disk space which often involves at least two adjacent vertebral levels is highly suggestive of which of the following?
● A. Tumor
● B. Potts disease
● C. Pyogenic infection
● D. Metastasis
● E. None of the above

Answer 4

C. Pyogenic infection

Question 5

What is the most common sacral neoplasm?
● A. Chordoma
● B. Osteoma
● C. Metastasis
● D. Giant cell tumor
● E. Teratoma

Answer 5

C. Metastasis

Question 6

In which type of sacral agenesis, there is partial bilaterally symmetric defects in the sacrum, iliac bones articulate with S1, and distal segments of the sacrum and coccyx fail to develop?
● A. Type 1
● B. Type 2
● C. Type 3
● D. Type 4
● E. Type 5

Answer 6

B. Type 2

Question 7

Nodular enhancing lesions in spine occur in all of the following except?
● A. Neurofibromatosis
● B. Drop metastasis
● C. Meningioma
● D. Schwannoma
● E. Neurofibroma

Answer 7

C. Meningioma

Question 8

Which of the following is the cause of atlantoaxial subluxation?
● A. Incompetence of transverse atlantal ligament (TAL) which can be due to rheumatoid arthritis (causes erosion of insertion point of TAL), traumatic, congenital laxity of TAL (in Down syndrome), retropharyngeal infection, or chronic steroid use
● B. Incompetence of odontoid process which can be due to odontoid fractures, os odontoideum, erosion of odontoid due to rheumatoid arthritis, neoplastic erosion of odontoid (metastasis), local infection, or congenital absence
● C. Congenital absence of tectorial membrane
● D. Basilar invagination
● E. Both A and B

Answer 8

E. Both A and B

Question 9

Which of the following are the etiologies of pathologic fracture of spine?
● A. Osteoporosis
● B. Neoplasm (metastasis, lymphoma, hemangioma)
● C. Infection
● D. Avascular necrosis of vertebral bodies (with excessive use of steroids)
● E. All of the above

Answer 9

E. All of the above

Question 10

All of the following are destructive lesions of spine except?
● A. Neoplastic (metastatic or primary bone tumors like chordoma, osteoid osteoma, hemangioma)
● B. Paget’s disease
● C. Infection like vertebral osteomyelitis
● D. Ankylosing spondylitis
● E. Chronic renal failure causing spondyloarthropathy resembling infection

Answer 10

B. Paget’s disease

Question 11

Following are the causes of vertebral hyperostosis except?
● A. Paget’s disease
● B. Osteoblastic metastasis (prostate in men and breast in women)
● C. Marfan’s syndrome or Ehlers Danlos syndrome
● D. Osteoid osteoma or osteoblastoma
● E. Bone island (also known as enostosis)

Answer 11

C. Marfan’s syndrome or Ehlers Danlos syndrome

Question 12

Which of the following is the most common sacral neoplasm?
● A. Metastasis
● B. Giant cell tumor
● C. Chordoma
● D. Teratoma
● E. None of the above

Answer 12

A. Metastasis

Question 13

Sacral agenesis is associated with increased incidence of spinal abnormalities like syrinx, tethered cord, lipoma, and lipomyelomeningocele. Which of the following are the types of sacral agenesis?
● A. Type 1: partial unilateral agenesis
● B. Type 2: partial bilaterally symmetric defects in the sacrum
● C. Type 3: total sacral agenesis plus iliac bone fuses with the lowest segment of the lumbar spine present
● D. Type 4: total sacral agenesis plus iliac bones fuse posteriorly in the midline
● E. All of the above

Answer 13

E. All of the above

Question 14

Following are the causes of enhancing nerve roots except?
● A. Tumor (meningeal carcinomatosis and lymphoma)
● B. Infection (CMV)
● C. Inflammatory (Guillain–Barre, arachnoiditis)
● D. Neurofibromatosis

Answer 14

D. Neurofibromatosis

Question 15

Which of the following are the differential of nodular enhancing lesions in the spinal canal?
● A. Neurofibromatosis
● B. Drop metastasis
● C. Neurofibroma
● D. Schwannoma
● E. All of the above

Answer 15

E. All of the above

Question 16

Which of the following are the differentials of intraspinal cysts?
● A. Spinal meningeal cysts
● B. Cystic neurofibroma
● C. Ependymoma
● D. Syringomyelia
● E. Dilated central canal
● F. All of the above

Answer 16

F. All of the above

Question 17

Which of the following are the differentials of diffuse enhancement of nerve roots/cauda equina?
● A. Guillain Barre
● B. Meningitis
● C. CMV
● D. Lymphoma
● E. Sarcoid
● F. All of the above

Answer 17

F. All of the above