Trauma imaging: bladder rupture: 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 · Trauma imaging: bladder rupture

Sample item

A man with a full bladder is injured in a road traffic collision and has lower abdominal pain, haematuria and ascites on CT. Which study differentiates intraperitoneal from extraperitoneal bladder rupture?

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

The answer and the reasoning

D. CT cystography with retrograde bladder filling

A retrograde filling of the bladder with dilute contrast and CT shows leak into the peritoneum, which needs surgical repair, or into the extraperitoneal pelvis, which is usually managed by catheter drainage. IV contrast alone is not enough because excreted contrast does not distend the bladder.

Option by option

  • A. Plain pelvic radiograph

    A plain film shows fractures only.

  • B. A standard CT with intravenous contrast only

    Standard IV phase CT may miss a rupture because the bladder is not distended.

  • C. Renal ultrasound

    Renal ultrasound does not show the bladder leak.

  • D. CT cystography with retrograde bladder filling (correct)

    Correct. Distending the bladder reveals the leak and its compartment.

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, CT cystography with retrograde bladder filling. A retrograde filling of the bladder with dilute contrast and CT shows leak into the peritoneum, which needs surgical repair, or into the extraperitoneal pelvis, which is usually managed by catheter drainage.

Why is "Plain pelvic radiograph" not the answer?

A plain film shows fractures only.

Why is "A standard CT with intravenous contrast only" not the answer?

Standard IV phase CT may miss a rupture because the bladder is not distended.

Why is "Renal ultrasound" not the answer?

Renal ultrasound does not show the bladder leak.

What concept does this question test?

It tests Trauma imaging: bladder rupture in Radiology. IV contrast alone is not enough because excreted contrast does not distend the bladder.

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 Trauma imaging: bladder rupture?

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.