Musculoskeletal imaging: traumatic spondylolisthesis of the axis: 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: traumatic spondylolisthesis of the axis

Sample item

A driver in a head-on collision with the neck hyperextended has a lateral cervical radiograph showing fractures through both pars interarticularis of C2 with anterior slip of C2 on C3. What is this injury?

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

The answer and the reasoning

C. Hangman fracture

Bilateral C2 pars fractures with anterolisthesis of C2 are called a Hangman fracture or traumatic spondylolisthesis of the axis. Hyperextension with axial load is the usual mechanism in road accidents.

Option by option

  • A. Clay-shoveler fracture

    A Clay-shoveler fracture is an avulsion of a lower cervical spinous process, usually C7.

  • B. Teardrop fracture of C5

    A teardrop fracture is a flexion injury with an anteroinferior vertebral fragment, usually at a lower cervical level.

  • C. Hangman fracture (correct)

    Correct. Bilateral C2 pars interarticularis fractures with C2 slip on C3 define a Hangman fracture.

  • D. Jefferson fracture

    A Jefferson fracture is a burst fracture of the C1 ring seen on open-mouth view.

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 C, Hangman fracture. Bilateral C2 pars fractures with anterolisthesis of C2 are called a Hangman fracture or traumatic spondylolisthesis of the axis.

Why is "Clay-shoveler fracture" not the answer?

A Clay-shoveler fracture is an avulsion of a lower cervical spinous process, usually C7.

Why is "Teardrop fracture of C5" not the answer?

A teardrop fracture is a flexion injury with an anteroinferior vertebral fragment, usually at a lower cervical level.

Why is "Jefferson fracture" not the answer?

A Jefferson fracture is a burst fracture of the C1 ring seen on open-mouth view.

What concept does this question test?

It tests Musculoskeletal imaging: traumatic spondylolisthesis of the axis in Radiology. Hyperextension with axial load is the usual mechanism in road accidents.

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: traumatic spondylolisthesis of the axis?

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.