If back pain with neurological deficit, what imaging would be best?

• A. MRI
• B. X-Ray
• C. CT Scan
• D. Ultrasound

Answer: (A)

Back pain with neurological deficits calls for looking at the spinal cord and surrounding soft tissues for compression or injury. MRI provides the best view of those structures: it clearly shows the spinal cord, nerve roots, intervertebral discs, ligaments, and any edema, hemorrhage, tumor, or infection. This makes it the most sensitive test for detecting nerve or cord compression and guiding urgent management.

X-ray can miss soft-tissue and early nerve compression and mainly shows bone alignment. CT scans are excellent for bony detail and fractures but are less sensitive for soft-tissue abnormalities and spinal cord issues. Ultrasound isn’t useful for evaluating the spine. So MRI is the most appropriate choice in this scenario.