Neuroradiology Department – CHLC, EPE
Critical Findings in Neuroradiology, Eds: Nunes RH, Abello AL, Castillo M, Springer, 1ª Ed, 2016, ISBN 978-3-319-27985-5
Spinal ligamentous injury (SLI) can affect children of any age and is almost invariably secondary to trauma. They differ from those of the adult, due to particular anatomic and biomechanical features of the developing spine. Specific, though not exclusive, pediatric entities include spinal cord injury without radiological abnormality (SCIWORA) and atlantoaxial rotatory fixation. Correct diagnosis of SLI is essential as spinal stability may be compromised and further injury to the spinal cord may ensue. Indirect signs of spinal instability must be recognized on computed tomography (CT) or radiographs as well as misleading normal anatomical variants in children. Magnetic resonance imaging (MRI) is the only imaging modality that can directly visualize SLI, making it the gold standard when lesions of the ligaments are suspected. Treatment and prognosis are determined by the severity of the injury. A brief review of pediatric SLI, followed by a recommended imaging approach, typical findings, differential diagnosis and reporting tips are discussed in this chapter.