Spine: psoriatic spondylitis: 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: psoriatic spondylitis

Sample item

A 45-year-old with scaly plaques and nail pitting has back pain. Radiographs show asymmetric sacroiliitis and bulky, comma-shaped, non-marginal ossification bridging the vertebral bodies at the thoracolumbar region. What is the diagnosis?

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

The answer and the reasoning

B. Psoriatic spondyloarthritis

Psoriatic and reactive spondylitis produce asymmetric sacroiliitis and bulky, non-marginal syndesmophytes. In ankylosing spondylitis the sacroiliitis is bilateral and symmetrical and the syndesmophytes are thin, marginal and vertical.

Option by option

  • A. Ankylosing spondylitis

    Ankylosing spondylitis gives symmetrical sacroiliitis and thin marginal syndesmophytes.

  • B. Psoriatic spondyloarthritis (correct)

    Correct. Skin disease with asymmetric sacroiliitis and non-marginal syndesmophytes fits psoriatic spondylitis.

  • C. Diffuse idiopathic skeletal hyperostosis

    DISH spares the sacroiliac joints and has flowing anterior ossification on the right side of the thoracic spine.

  • D. Degenerative spondylosis

    Degenerative spondylosis produces osteophytes at the disc margins and not asymmetric sacroiliitis.

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 Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Psoriatic spondyloarthritis. Psoriatic and reactive spondylitis produce asymmetric sacroiliitis and bulky, non-marginal syndesmophytes.

Why is "Ankylosing spondylitis" not the answer?

Ankylosing spondylitis gives symmetrical sacroiliitis and thin marginal syndesmophytes.

Why is "Diffuse idiopathic skeletal hyperostosis" not the answer?

DISH spares the sacroiliac joints and has flowing anterior ossification on the right side of the thoracic spine.

Why is "Degenerative spondylosis" not the answer?

Degenerative spondylosis produces osteophytes at the disc margins and not asymmetric sacroiliitis.

What concept does this question test?

It tests Spine: psoriatic spondylitis in Orthopaedics. In ankylosing spondylitis the sacroiliitis is bilateral and symmetrical and the syndesmophytes are thin, marginal and vertical.

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: psoriatic spondylitis?

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.