Musculoskeletal imaging: prevertebral soft tissue swelling: 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 · Musculoskeletal imaging: prevertebral soft tissue swelling

Sample item

In a trauma patient, a lateral cervical radiograph shows prevertebral soft-tissue thickness of 12 mm at the level of C2 in an adult. How should this be interpreted?

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

The answer and the reasoning

B. Prevertebral haematoma suggesting occult cervical spine injury

Prevertebral soft tissue should measure less than about 7 mm anterior to C2 in adults. Thickening in trauma suggests haematoma from a bony or ligamentous injury and needs CT or MRI even if the bones look normal.

Option by option

  • A. Artefact from neck flexion

    Crying or expiration can widen the soft tissue in infants, but this does not explain 12 mm in an adult trauma patient.

  • B. Prevertebral haematoma suggesting occult cervical spine injury (correct)

    Correct. Thickening beyond about 7 mm at C2 after trauma suggests haematoma from an occult cervical injury.

  • C. Normal finding at this level in an adult

    The normal adult measurement at C2 is less than about 7 mm, so 12 mm is abnormal.

  • D. Retropharyngeal air from oesophageal perforation

    Retropharyngeal air would appear as gas lucency, not as a uniform soft-tissue widening.

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 B, Prevertebral haematoma suggesting occult cervical spine injury. Prevertebral soft tissue should measure less than about 7 mm anterior to C2 in adults.

Why is "Artefact from neck flexion" not the answer?

Crying or expiration can widen the soft tissue in infants, but this does not explain 12 mm in an adult trauma patient.

Why is "Normal finding at this level in an adult" not the answer?

The normal adult measurement at C2 is less than about 7 mm, so 12 mm is abnormal.

Why is "Retropharyngeal air from oesophageal perforation" not the answer?

Retropharyngeal air would appear as gas lucency, not as a uniform soft-tissue widening.

What concept does this question test?

It tests Musculoskeletal imaging: prevertebral soft tissue swelling in Radiology. Thickening in trauma suggests haematoma from a bony or ligamentous injury and needs CT or MRI even if the bones look normal.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Musculoskeletal imaging: prevertebral soft tissue swelling?

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.