Inflicted T12 fracture-dislocation: CT/MRI correlation and mechanistic implications

Area of Science:

• Pediatric Radiology
• Forensic Imaging
• Skeletal Trauma Analysis

Background:

• Neurocentral synchondrosis fractures are rare injuries, particularly in infants.
• Identifying specific injury patterns is crucial for diagnosing non-accidental trauma.
• Cross-sectional imaging plays a vital role in evaluating complex spinal injuries.

Observation:

• A case of thoracolumbar neurocentral synchondrosis fracture-dislocation in an abused infant is presented.
• CT and MRI revealed characteristic morphologic features of this fracture type.
• Associated cervical and sacral spine injuries were identified on imaging.

Findings:

• The imaging findings provide strong evidence for a mechanism of massive hyperflexion.
• Axial spinal loading is implicated as a contributing factor to the observed injuries.
• The pattern of injury is consistent with inflicted trauma.

Implications:

• This case highlights the importance of recognizing specific spinal injury patterns in suspected child abuse.
• Radiologists must be aware of these findings to aid in the diagnosis of abusive head trauma.
• Understanding the biomechanics of these injuries can assist in forensic investigations.