TY  - JOUR
PY  - 2010//
TI  - What are the clinical and radiological characteristics of spinal injuries from physical abuse: a systematic review
JO  - Archives of disease in childhood
A1  - Kemp, A. M.
A1  - Joshi, A.
A1  - Mann, Marilynne
A1  - Tempest, V.
A1  - Liu, Aizhong
A1  - Holden, S.
A1  - Maguire, S.
SP  - 355
EP  - 360
VL  - 95
IS  - 5
N2  - AIM: Systematic review of: "What are the clinical and radiological characteristics of inflicted spinal injury?" METHODS: Literature search of 20 electronic databases, websites, references and bibliographies (1950- 2009) using selected keywords. Critical appraisal: by two trained reviewers, (a third review, if discrepant). Inclusion criteria: primary studies of inflicted spinal injury in children <18 years, alive at presentation, with a high surety of diagnosis of abuse and sufficient detail to analyse. RESULTS: 19 studies of 25 children were included. Twelve children, (median age 5 months) had cervical injury. In seven cases the clinical signs of spinal injury were masked by respiratory symptoms and impaired levels of consciousness, six of these children had co-existent inflicted head trauma. Twelve children with thoraco-lumbar injury (median age 13.5 months), 10/12 had lesions at T11-L2, 9/12 were fracture dislocations. All children had focal signs: 10/12 had lumbar kyphosis or thoraco-lumbar swelling, two had focal neurology. One child had cervical, thoracic and sacral injuries. CONCLUSIONS: Spinal injury is a potentially devastating inflicted injury in infants and young children. The published evidence-base is limited. However this case series leads us to recommend that any clinical or radiological indication of spinal injury warrant a MRI. In children undergoing brain MRI for abusive head trauma, consideration should be given to including a MRI of the spine. All skeletal surveys in children with suspected abuse should include lateral views of the cervical and thoraco-lumbar spine. Further prospective comparative studies would define the discriminating features of inflicted spinal injuries.<p /> <p>Language: en</p>
LA  - en
SN  - 0003-9888
UR  - http://dx.doi.org/10.1136/adc.2009.169110
ID  - ref1
ER  -