Avulsion of the spinous processes caused by infant abuse

In infants who are victims of abuse, fractures of the thoracic and lumbar spinous processes are likely to be the result of violent shaking. While initial radiographs may appear normal, subsequent studies may reveal extensive ossification within the adjacent soft tissues. These abnormalities are subtle and easily overlooked, in part explaining the rarity of such reports in the literature. The authors recommend that lateral views of the vertebral column be obtained whenever infant abuse is suspected.