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Spinal ligamentous injury in abusive head trauma: a pictorial review

Authors
  • Haq, Iqbal1
  • Jayappa, Sateesh1
  • Desai, Shivang K.2
  • Ramakrishnaiah, Raghu1
  • Choudhary, Arabinda K.1
  • 1 Department of Radiology,University of Arkansas for Medical Sciences (UAMS),, 4301 W. Markham St., Slot 556, Little Rock, AR, 72205, USA , Little Rock (United States)
  • 2 University of Texas Southwestern Medical Center, Dallas, TX, USA , Dallas (United States)
Type
Published Article
Journal
Pediatric Radiology
Publisher
Springer-Verlag
Publication Date
May 17, 2021
Volume
51
Issue
6
Pages
971–979
Identifiers
DOI: 10.1007/s00247-020-04922-8
Source
Springer Nature
Keywords
License
Yellow

Abstract

There is growing evidence of spine injury in abusive head trauma (AHT). Historically, spine injury was considered rare in AHT because of a lack of attributable clinical symptoms or signs and a lack of advanced imaging. Increased use of MRI in AHT has been instrumental in helping identify evidence of ligamentous injuries of the spine. These findings can be difficult to identify on autopsy because of the size and location of the ligaments. Because spinal injury in AHT mostly involves ligamentous and soft tissues and only rarely involves bony fractures, more than 90% of the injury findings are missed on CT or radiography of the spine. Investigation of these findings and the injury patterns should lead to a better understanding of the mechanism of spinal injury. In this pictorial review, we describe the various manifestations of spinal ligamentous injury in AHT, as seen on MRI, in children younger than 48 months.

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