PDF herunterladen
Semin Musculoskelet Radiol 2023; 27(05): 566-579
DOI: 10.1055/s-0043-1771333
Review Article

Update on Pediatric Spine Imaging

Stijn Schatteman
1   Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
,
Jacob Jaremko
2   Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Lennart Jans
1   Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
,
Nele Herregods
1   Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
    Lizenzen und Reprints

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.

Keywords

spine - pediatric - imaging


Publikationsverlauf

Artikel online veröffentlicht:
10. Oktober 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Calvo-Muñoz I, Kovacs FM, Roqué M, Gago Fernández I, Seco Calvo J. Risk factors for low back pain in childhood and adolescence: a systematic review. Clin J Pain 2018; 34 (05) 468-484
    CrossrefPubMedSuche in Google Scholar
  • 2 Yang S, Werner BC, Singla A, Abel MF. Low back pain in adolescents: a 1-year analysis of eventual diagnoses. J Pediatr Orthop 2017; 37 (05) 344-347
    CrossrefPubMedSuche in Google Scholar
  • 3 Booth TN, Iyer RS, Falcone Jr RA. et al; Expert Panel on Pediatric Imaging. ACR Appropriateness Criteria® Back Pain-Child. J Am Coll Radiol 2017; 14 (5S): S13-S24
    CrossrefPubMedSuche in Google Scholar
  • 4 Hutchins TA, Peckham M, Shah LM. et al; Expert Panel on Neurological Imaging. ACR Appropriateness Criteria® Low Back Pain: 2021 Update. J Am Coll Radiol 2021; 18 (11S): S361-S379
    CrossrefPubMedSuche in Google Scholar
  • 5 Achar S, Yamanaka J. Back pain in children and adolescents. Am Fam Physician 2020; 102 (01) 19-28
    PubMedSuche in Google Scholar
  • 6 Byrd SE, Comiskey EM. Postnatal maturation and radiology of the growing spine. Neurosurg Clin N Am 2007; 18 (03) 431-461
    CrossrefPubMedSuche in Google Scholar
  • 7 Rodriguez DP, Poussaint TY. Imaging of back pain in children. AJNR Am J Neuroradiol 2010; 31 (05) 787-802
    CrossrefPubMedSuche in Google Scholar
  • 8 Rossi A, Martinetti C, Morana G, Severino M, Tortora D. Diagnostic approach to pediatric spine disorders. Magn Reson Imaging Clin N Am 2016; 24 (03) 621-644
    CrossrefPubMedSuche in Google Scholar
  • 9 Trapp B, de Andrade Lourenção Freddi T, de Oliveira Morais Hans M. et al. A practical approach to diagnosis of spinal dysraphism. Radiographics 2021; 41 (02) 559-575
    CrossrefPubMedSuche in Google Scholar
  • 10 Tortori-Donati P, Rossi A, Cama A. Spinal dysraphism: a review of neuroradiological features with embryological correlations and proposal for a new classification. Neuroradiology 2000; 42 (07) 471-491
    CrossrefPubMedSuche in Google Scholar
  • 11 Orman G, Tijssen MPM, Seyfert D, Gassner I, Huisman TAGM. Ultrasound to evaluate neonatal spinal dysraphism: a first-line alternative to CT and MRI. J Neuroimaging 2019; 29 (05) 553-564
    CrossrefPubMedSuche in Google Scholar
  • 12 Kucera JN, Coley I, O'Hara S, Kosnik EJ, Coley BD. The simple sacral dimple: diagnostic yield of ultrasound in neonates. Pediatr Radiol 2015; 45 (02) 211-216
    CrossrefPubMedSuche in Google Scholar
  • 13 Shields LBE, Mutchnick IS, Peppas DS, Rosenberg E. Importance of physical examination and imaging in the detection of tethered cord syndrome. Glob Pediatr Health 2019; 6: X19851419
    PubMedSuche in Google Scholar
  • 14 Tuite GF, Thompson DNP, Austin PF, Bauer SB. Evaluation and management of tethered cord syndrome in occult spinal dysraphism: recommendations from the International Children's Continence Society. Neurourol Urodyn 2018; 37 (03) 890-903
    CrossrefPubMedSuche in Google Scholar
  • 15 Nair N, Sreenivas M, Gupta AK, Kandasamy D, Jana M. Neonatal and infantile spinal sonography: a useful investigation often underutilized. Indian J Radiol Imaging 2016; 26 (04) 493-501
    Thieme ConnectPubMedSuche in Google Scholar
  • 16 Strahle J, Muraszko KM, Garton HJL. et al. Syrinx location and size according to etiology: identification of Chiari-associated syrinx. J Neurosurg Pediatr 2015; 16 (01) 21-29
    CrossrefPubMedSuche in Google Scholar
  • 17 Joseph RN, Batty R, Raghavan A, Sinha S, Griffiths PD, Connolly DJA. Management of isolated syringomyelia in the paediatric population—a review of imaging and follow-up in a single centre. Br J Neurosurg 2013; 27 (05) 683-686
    CrossrefPubMedSuche in Google Scholar
  • 18 Timpone VM, Patel SH. MRI of a syrinx: is contrast material always necessary?. AJR Am J Roentgenol 2015; 204 (05) 1082-1085
    CrossrefPubMedSuche in Google Scholar
  • 19 Heiskanen S, Syvänen J, Helenius I. et al. Increasing prevalence and high risk of associated anomalies in congenital vertebral defects: a population-based study. J Pediatr Orthop 2022; 42 (05) e538-e543
    CrossrefPubMedSuche in Google Scholar
  • 20 Colafati GS, Marrazzo A, Cirillo M. et al. The pediatric spine. Semin Musculoskelet Radiol 2021; 25 (01) 137-154
    Thieme ConnectPubMedSuche in Google Scholar
  • 21 Fucs PM, Meves R, Yamada HH. Spinal infections in children: a review. Int Orthop 2012; 36 (02) 387-395
    CrossrefPubMedSuche in Google Scholar
  • 22 Faingold R, Saigal G, Azouz EM, Morales A, Albuquerque PAB. Imaging of low back pain in children and adolescents. Semin Ultrasound CT MR 2004; 25 (06) 490-505
    CrossrefPubMedSuche in Google Scholar
  • 23 James SLJ, Davies AM. Imaging of infectious spinal disorders in children and adults. Eur J Radiol 2006; 58 (01) 27-40
    CrossrefPubMedSuche in Google Scholar
  • 24 Raghavan M, Lazzeri E, Palestro CJ. Imaging of spondylodiscitis. Semin Nucl Med 2018; 48 (02) 131-147
    CrossrefPubMedSuche in Google Scholar
  • 25 Tyagi R. Spinal infections in children: a review. J Orthop 2016; 13 (04) 254-258
    CrossrefPubMedSuche in Google Scholar
  • 26 Hemke R, Herregods N, Jaremko JL. et al. Imaging assessment of children presenting with suspected or known juvenile idiopathic arthritis: ESSR-ESPR points to consider. Eur Radiol 2020; 30 (10) 5237-5249
    CrossrefPubMedSuche in Google Scholar
  • 27 Shah A, Rosenkranz M, Thapa M. Review of spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO): what radiologists need to know about CRMO and its imitators. Clin Imaging 2022; 81: 122-135
    CrossrefPubMedSuche in Google Scholar
  • 28 Jurik AG, Klicman RF, Simoni P, Robinson P, Teh J. SAPHO and CRMO: the value of imaging. Semin Musculoskelet Radiol 2018; 22 (02) 207-224
    Thieme ConnectPubMedSuche in Google Scholar
  • 29 Jaremko JL, Siminoski K, Firth GB. et al; Canadian STOPP Consortium National Pediatric Bone Health Working Group. Common normal variants of pediatric vertebral development that mimic fractures: a pictorial review from a national longitudinal bone health study. Pediatr Radiol 2015; 45 (04) 593-605
    CrossrefPubMedSuche in Google Scholar
  • 30 Huisman TAGM, Wagner MW, Bosemani T, Tekes A, Poretti A. Pediatric spinal trauma. J Neuroimaging 2015; 25 (03) 337-353
    CrossrefPubMedSuche in Google Scholar
  • 31 Mistry D, Munjal H, Ellika S, Chaturvedi A. Pediatric spine trauma: a comprehensive review. Clin Imaging 2022; 87: 61-76
    CrossrefPubMedSuche in Google Scholar
  • 32 Booth TN. Cervical spine evaluation in pediatric trauma. AJR Am J Roentgenol 2012; 198 (05) W417-25
    CrossrefPubMedSuche in Google Scholar
  • 33 Kumar Y, Hayashi D. Role of magnetic resonance imaging in acute spinal trauma: a pictorial review. BMC Musculoskelet Disord 2016; 17 (01) 310
    CrossrefPubMedSuche in Google Scholar
  • 34 Kadam G, Narsinghpura K, Deshmukh S, Desai S. Traumatic lumbar vertebral ring apophysis fracture with disk herniation in an adolescent. Radiol Case Rep 2017; 12 (02) 427-430
    CrossrefPubMedSuche in Google Scholar
  • 35 Berger RG, Doyle SM. Spondylolysis 2019 update. Curr Opin Pediatr 2019; 31 (01) 61-68
    CrossrefPubMedSuche in Google Scholar
  • 36 Kim HJ, Green DW. Spondylolysis in the adolescent athlete. Curr Opin Pediatr 2011; 23 (01) 68-72
    CrossrefPubMedSuche in Google Scholar
  • 37 Calloni SF, Huisman TA, Poretti A, Soares BP. Back pain and scoliosis in children: when to image, what to consider. Neuroradiol J 2017; 30 (05) 393-404
    CrossrefPubMedSuche in Google Scholar
  • 38 Negrini S, Donzelli S, Aulisa AG. et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord 2018; 13: 3
    CrossrefPubMedSuche in Google Scholar
  • 39 Pasha S, Rajapaske CR, Reddy R. et al. Quantitative imaging of the spine in adolescent idiopathic scoliosis: shifting the paradigm from diagnostic to comprehensive prognostic evaluation. Eur J Orthop Surg Traumatol 2021; 31 (07) 1273-1285
    CrossrefPubMedSuche in Google Scholar
  • 40 Tully PA, Edwards BA, Mograby O. et al. Should all paediatric patients with presumed idiopathic scoliosis undergo MRI screening for neuro-axial disease?. Childs Nerv Syst 2018; 34 (11) 2173-2178
    CrossrefPubMedSuche in Google Scholar
  • 41 Gokce E, Beyhan M. Radiological imaging findings of Scheuermann disease. World J Radiol 2016; 8 (11) 895-901
    CrossrefPubMedSuche in Google Scholar
  • 42 Sorensen KH. Scheuermann's Juvenile Kyphosis: Clinical Practice, Appearances, Radiography, Aetiology and Prognosis [dissertation]. Copenhagen, Denmark: Aarhus University; 2001
    Suche in Google Scholar
  • 43 Haque S, Bilal Shafi BB, Kaleem M. Imaging of torticollis in children. Radiographics 2012; 32 (02) 557-571
    CrossrefPubMedSuche in Google Scholar
  • 44 Rossi A, Gandolfo C, Morana G, Tortori-Donati P. Tumors of the spine in children. Neuroimaging Clin N Am 2007; 17 (01) 17-35
    CrossrefPubMedSuche in Google Scholar
  • 45 Menashe SJ, Iyer RS. Pediatric spinal neoplasia: a practical imaging overview of intramedullary, intradural, and osseous tumors. Curr Probl Diagn Radiol 2013; 42 (06) 249-265
    CrossrefPubMedSuche in Google Scholar
  • 46 Rogers SN, Udayasankar U, Pruthi S. et al. Imaging of pediatric spine and spinal cord tumors: a COG Diagnostic Imaging Committee/SPR Oncology Committee/ASPNR White Paper. Pediatr Blood Cancer 2023; 70 (Suppl. 04) e30150
    CrossrefPubMedSuche in Google Scholar