Imaging of the spine for traumatic and nontraumatic etiologies

Abstract

Key Points: □ Imaging in older children and adolescent victims of trauma should be limited to those who have any of the following criteria: (1) altered neurologic function, (2) intoxication, (3) midline posterior bony cervical spine tenderness, and (4) other painful distracting injury (moderate evidence). □ In contrast to adults, children with back pain should undergo evaluation to understand the cause of back pain. Imaging is clearly indicated in children and adolescents when infection, tumor, or scoliosis is suspected. Imaging is probably not indicated in subjects with symptoms of relatively short duration and intensity and in whom the physical examination is benign (insufficient evidence). □ Spondylolysis should be suspected in adolescent athletes with exercise-induced low back pain. Because spondylolysis may not be apparent on radiography, SPECT or CT is indicated if clinical suspicion is high (limited evidence). © 2010 Springer-Verlag New York.