Spine: 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

Sample item

An adolescent gymnast has low back pain on extension. An oblique lumbar radiograph shows a break in the neck of the 'Scotty dog'. What does this indicate?

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

The answer and the reasoning

C. A defect in the pars interarticularis (spondylolysis)

On an oblique lumbar view the pars interarticularis forms the neck of the Scotty dog. A defect there is spondylolysis, which may allow forward slip of the vertebra (spondylolisthesis), most commonly at L5 over S1 in the isthmic type.

Option by option

  • A. Destruction of the pedicle by metastasis

    Pedicle destruction produces the 'winking owl' sign, which shows a missing pedicle rather than a neck defect.

  • B. Facet joint osteoarthritis

    Facet arthritis changes involve the joint region and do not produce a break in the neck.

  • C. A defect in the pars interarticularis (spondylolysis) (correct)

    The neck of the Scotty dog is the pars, so a break there shows spondylolysis.

  • D. Fracture of the transverse process

    The transverse process forms the nose of the Scotty dog, not the neck.

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 C, A defect in the pars interarticularis (spondylolysis). On an oblique lumbar view the pars interarticularis forms the neck of the Scotty dog.

Why is "Destruction of the pedicle by metastasis" not the answer?

Pedicle destruction produces the 'winking owl' sign, which shows a missing pedicle rather than a neck defect.

Why is "Facet joint osteoarthritis" not the answer?

Facet arthritis changes involve the joint region and do not produce a break in the neck.

Why is "Fracture of the transverse process" not the answer?

The transverse process forms the nose of the Scotty dog, not the neck.

What concept does this question test?

It tests Spine in Orthopaedics. A defect there is spondylolysis, which may allow forward slip of the vertebra (spondylolisthesis), most commonly at L5 over S1 in the isthmic type.

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 Spine?

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.