MSK imaging: DISH: 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 · MSK imaging: DISH

Sample item

An obese older man with diabetes and mild back stiffness has a lateral thoracic spine radiograph showing flowing calcification along the anterior aspect of at least four contiguous vertebrae, with preserved disc height. What is the diagnosis?

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

The answer and the reasoning

B. Diffuse idiopathic skeletal hyperostosis

DISH shows thick flowing ossification of the anterior longitudinal ligament along four or more levels, preserved disc spaces and normal sacroiliac joints. Ankylosing spondylitis has thin syndesmophytes and sacroiliitis.

Option by option

  • A. Ankylosing spondylitis

    Ankylosing spondylitis shows sacroiliitis and thin marginal syndesmophytes.

  • B. Diffuse idiopathic skeletal hyperostosis (correct)

    Correct. Flowing anterior ossification with preserved discs defines DISH.

  • C. Degenerative disc disease

    Degenerative disease narrows the discs and forms osteophytes.

  • D. Spinal tuberculosis

    Tuberculosis destroys vertebral bodies and discs.

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.

More Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Diffuse idiopathic skeletal hyperostosis. DISH shows thick flowing ossification of the anterior longitudinal ligament along four or more levels, preserved disc spaces and normal sacroiliac joints.

Why is "Ankylosing spondylitis" not the answer?

Ankylosing spondylitis shows sacroiliitis and thin marginal syndesmophytes.

Why is "Degenerative disc disease" not the answer?

Degenerative disease narrows the discs and forms osteophytes.

Why is "Spinal tuberculosis" not the answer?

Tuberculosis destroys vertebral bodies and discs.

What concept does this question test?

It tests MSK imaging: DISH in Radiology. Ankylosing spondylitis has thin syndesmophytes and sacroiliitis.

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 MSK imaging: DISH?

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.