Spine: Modic changes: 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: Modic changes

Sample item

MRI of a patient with chronic low back pain shows low signal on T1 and high signal on T2 in the vertebral endplate and subchondral marrow adjacent to a degenerate disc. Which Modic type is this?

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

The answer and the reasoning

B. Type 1, indicating oedema and inflammation

Modic type 1 changes show low T1 and high T2 signal, representing bone marrow oedema and inflammation, and are often linked to painful active degeneration. Type 2 shows high signal on both T1 and T2, representing fatty marrow replacement. Type 3 shows low signal on both sequences, indicating sclerosis.

Option by option

  • A. Type 3, indicating sclerosis

    Type 3 shows low signal on both T1 and T2.

  • B. Type 1, indicating oedema and inflammation (correct)

    Correct. Low T1 and high T2 signal define Modic type 1.

  • C. Normal marrow

    Normal marrow would not show these endplate signal changes.

  • D. Type 2, indicating fatty replacement

    Type 2 shows high T1 signal from fat.

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 B, Type 1, indicating oedema and inflammation. Modic type 1 changes show low T1 and high T2 signal, representing bone marrow oedema and inflammation, and are often linked to painful active degeneration.

Why is "Type 3, indicating sclerosis" not the answer?

Type 3 shows low signal on both T1 and T2.

Why is "Normal marrow" not the answer?

Normal marrow would not show these endplate signal changes.

Why is "Type 2, indicating fatty replacement" not the answer?

Type 2 shows high T1 signal from fat.

What concept does this question test?

It tests Spine: Modic changes in Orthopaedics. Type 2 shows high signal on both T1 and T2, representing fatty marrow replacement. Type 3 shows low signal on both sequences, indicating sclerosis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: Modic changes?

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.