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Update on Pediatric Spine Imaging
Stijn Schatteman1, Jacob Jaremko2, Lennart Jans1
1Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium.
Insights
Diagnostic imaging is crucial for identifying pediatric spinal disorders when clinical evaluation is challenging. Red flags like persistent pain or neurological changes warrant further investigation with imaging, interpreted alongside clinical data.
Area of Science:
- Pediatric Radiology
- Spinal Imaging
Background:
- Clinical evaluation of pediatric spine conditions can be difficult.
- Diagnostic imaging plays a vital role in detecting diverse spinal disorders in children.
- Muscular strain is the most common cause of back pain in children and typically does not require imaging.
Purpose of the Study:
- To review common and important pediatric spine pathologies requiring imaging.
- To emphasize the importance of integrating clinical history, physical examination, and laboratory findings with imaging results for accurate diagnosis.
Main Methods:
- Discussion of imaging modalities for pediatric spine pathologies.
- Review of congenital, developmental, traumatic, infectious, inflammatory, and neoplastic conditions of the pediatric spine.
Main Results:
- Imaging is essential for diagnosing various pediatric spinal disorders beyond muscular strain.
- Specific red flags (e.g., age < 5 years, constant/night pain, radicular pain, duration > 4 weeks, abnormal neurological exam) indicate the need for further investigation.
- Accurate diagnosis relies on correlating imaging findings with clinical and laboratory data.
Conclusions:
- Diagnostic imaging is indispensable for evaluating pediatric spinal disorders.
- A comprehensive approach combining clinical assessment, physical examination, laboratory findings, and imaging is necessary for accurate diagnosis and management of pediatric spine conditions.
Abstract:
The spine is often difficult to evaluate clinically in children, increasing the importance of diagnostic imaging to detect a wide variety of spinal disorders ranging from congenital abnormalities to severe infections. Clinical history and physical examination can help determine whether imaging is needed and which imaging technique would be best. The most common cause for back pain, even in children, is muscular strain/spasm that does not require any imaging. However, red flags such as pain at age < 5 years, constant pain, night pain, radicular pain, pain lasting > 4 weeks, or an abnormal neurologic examination may require further investigation. Imaging can be of great value for diagnosis but must be interpreted along with the clinical history, physical examination, and laboratory findings to achieve an accurate diagnosis. We discuss imaging for the most common and/or important spine pathologies in children: congenital and developmental pathologies, trauma, infectious processes, inflammatory causes, and tumors.
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