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NEET-PG 2019 — Radiology

Q: A 75-year-old female has chronic backache. X-ray spine is shown. What is the most likely diagnosis?

Osteoporosis. ***Osteoporosis*** - The X-ray shows diffuse **decreased bone density**, **vertebral body height loss** (compression fractures), and a **biconcave** (codfish) appearance of the vertebral bodies, all classic signs of osteoporosis. - The patient's age (75-year-old female) and chronic backache are consistent with **postmenopausal osteoporosis**, a common cause of such spinal changes. *Pott's spine* - Pott's spine, or **tuberculous spondylitis**, typically presents with **destruction of vertebral bodies** and **intervertebral discs**, often with an associated **paravertebral abscess**. - The X-ray imaging does not show signs of significant disc space narrowing, vertebral destruction, or soft tissue masses that would indicate an infectious process like Pott's spine. *Spondylolisthesis* - **Spondylolisthesis** involves the **anterior slippage of one vertebra over another**, which would be evident as a misalignment in the lateral spinal X-ray. - The image does not demonstrate any significant forward displacement of a vertebral body relative to the one below it. *Spondylodiscitis* - **Spondylodiscitis** is an **infection of the intervertebral disc space** and adjacent vertebral bodies, typically presenting with **erosions** and **destruction at the endplates** and **narrowing of the disc space**. - While there is some disc space narrowing due to degenerative changes, the prominent features of diffuse osteopenia and vertebral compression fractures are not typical of an acute or chronic infection.

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Q11

A 75-year-old female has chronic backache. X-ray spine is shown. What is the most likely diagnosis?