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Whole spine MRI suspected child abuse

14/01/2022

According to an article in ARRS' American Journal of Roentgenology (AJR), whole-spine MRI commonly demonstrates isolated thoracolumbar injuries in children with suspected abusive head trauma.

"When performing spine MRI in children with suspected abusive head trauma, whole-spine MRI rather than cervical spine MRI may be warranted, to avoid missing isolated thoracolumbar injuries," clarified first author Boaz Karmazyn from Indiana University School of Medicine, Riley Hospital for Children. Karmazyn and team's retrospective study included 256 children (170 boys, 86 girls; mean age, 5.9 months) who, from January 2019 to December 2020, underwent skeletal survey and head MRI for suspected child abuse.

Image: Whole-spine MRI; Copyright: American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

Whole spine MRI of 16-Month-Old Boy, Born at Gestational Age of 28 Weeks, Presenting With Unexplained Facial Burns.

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Children with suspected abusive head trauma also underwent whole-spine MRI, per institutional protocol. Diagnoses for abusive head trauma were established via clinical record review, as well as injuries described in skeletal survey, head MRI, and head CT (if performed) reports.

Of the 148 total children with suspected abusive head trauma who underwent whole-spine MRI, 23.0 percent of examinations demonstrated injuries localized to the thoracolumbar spine. Injuries were localized to the thoracolumbar spine in 51.1 percent of examinations with major findings: subdural hematoma, epidural hematoma, ligamentous injury, or fracture not identified by skeletal survey.

"This study represents the largest reported series to our knowledge of children with suspected abusive head trauma who were evaluated by whole-spine MRI," added the authors of this AJR article.

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