Whole spine MRI should be used to assess children with suspected abusive head trauma

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Whole spine magnetic resonance imaging (MRI) rather than cervical spine MRI should be used in children with suspected abusive head trauma in order to avoid missing isolated thoracolumbar injuries, according to a recent article published in the American Roentgen Ray Society’s (ARRS’s) American Journal of Roentgenology.

First author, Boaz Karmazyn (Riley Hospital for Children, Indianapolis, USA), and his team, conducted a retrospective study which 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.

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 computed tomography (if performed) reports.

Of the 148 total children with suspected abusive head trauma who underwent whole-spine MRI, 23% of examinations demonstrated injuries localised to the thoracolumbar spine. Injuries were localised to the thoracolumbar spine in 51.1% 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 study authors.

Founded in 1900, the ARRS is the first and oldest radiological society in North America.


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