NBCE Part 4 Chiro Practice 202 Exam Questions & Answers 2026 (11–20)

Question 1

Which modality is most appropriate for evaluating a suspected stress fracture that is not visible on initial radiographs?

TheoryPractice · Accepted Answer

MRI. MRI can detect bone marrow edema associated with stress fractures before they become visible on plain radiographs. It has higher sensitivity for early stress reactions and fractures that haven't progressed to the point of visible cortical disruption on X-ray.

Question 2

What radiographic finding is most consistent with rheumatoid arthritis in the cervical spine?

TheoryPractice · Accepted Answer

Atlantoaxial subluxation. Atlantoaxial subluxation is a characteristic finding in rheumatoid arthritis of the cervical spine. It occurs due to erosion of the transverse and alar ligaments by inflammatory pannus, allowing excessive movement between C1 and C2.

Question 3

Which of the following represents the most appropriate patient positioning for a lateral thoracic spine radiograph?

TheoryPractice · Accepted Answer

True lateral with arms raised above the head. True lateral positioning with arms raised above the head removes superimposition of the shoulders over the thoracic spine, allowing better visualization of the vertebral bodies, disc spaces, and posterior elements in the thoracic region.

Question 4

In a patient with suspected cervical radiculopathy, which imaging finding most directly correlates with the patient's symptoms?

TheoryPractice · Accepted Answer

Foraminal stenosis at the affected level. Foraminal stenosis directly correlates with radiculopathy symptoms as it compresses the nerve root as it exits the spinal canal through the neural foramen. This compression typically produces dermatomal pain, paresthesia, and possibly motor weakness in the affected nerve distribution.

Question 5

What radiographic measurement best indicates lumbar instability on flexion-extension views?

TheoryPractice · Accepted Answer

Sagittal translation greater than 4-5mm. Sagittal translation greater than 4-5mm between adjacent vertebrae on flexion-extension views is considered abnormal and indicates potential instability. This measurement quantifies the excessive movement that may be contributing to the patient's symptoms.

Question 6

Which of the following radiographic findings would be classified as a congenital variant rather than pathology?

TheoryPractice · Accepted Answer

Transitional vertebrae. Transitional vertebrae (such as lumbarization of S1 or sacralization of L5) are congenital variants that result from developmental alterations in segmentation. While they may be associated with certain conditions, they are not pathological in themselves but represent normal anatomic variations.

Question 7

A 25-year-old patient with suspected lumbar disc herniation has no red flags on examination. What is the most appropriate initial imaging recommendation?

TheoryPractice · Accepted Answer

No imaging; trial of conservative care for 4-6 weeks. Conservative care without imaging is recommended initially for suspected disc herniations without red flags. Most disc herniations improve with conservative management, and imaging is only indicated if symptoms persist beyond 4-6 weeks or if neurological symptoms worsen.

Question 8

Which radiographic line is used to detect cervical spine subluxation on a lateral view?

TheoryPractice · Accepted Answer

George's line. George's line (posterior vertebral body line) is drawn along the posterior aspects of the vertebral bodies on a lateral cervical radiograph. Any displacement or step-off along this line suggests subluxation or anterolisthesis of a vertebra.

Question 9

What is the most appropriate radiation protection measure for a female patient of childbearing age requiring lumbar spine radiographs?

TheoryPractice · Accepted Answer

Determine pregnancy status before performing the examination. Determining pregnancy status before performing radiographs is essential for female patients of childbearing age. This allows for informed decision-making about the risks and benefits of the procedure and consideration of alternative imaging if pregnancy is confirmed.

Question 10

What radiographic finding is most consistent with osteoporosis on a standard radiograph?

TheoryPractice · Accepted Answer

Increased radiolucency with prominent trabecular patterns. Increased radiolucency with prominent trabecular patterns is the classic radiographic appearance of osteoporosis. As bone mineral density decreases, the cortical bone thins and the trabecular pattern becomes more prominent, creating a characteristic appearance of increased radiolucency.

NBCE Part 4 Chiro Practice 202 Exam Questions & Answers 2026 (11–20)

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