Keywords:
Trauma, Paediatric, CT, MR, Conventional radiography, Diagnostic procedure
Authors:
J. B. Davies, R. Berkeley, D. Pefanis, W. Tilden, R. Wheeler, S. G. Cross; London/UK
Conclusion
Paediatric CSI is rare and was only identified in patients suffering high energy trauma in our cases series.
Our limited data suggest that the prevalence of upper c-spine injury in this patient group is high (5/7,
71%) although the very limited number of cases precludes any meaningful statistical analysis.
Our data also suggest that CT occult,
significant soft tissue injuries which may result in spinal instability are also common,
occurring in 1/7 (14.3%) of cases.
It is therefore important that the reporting radiologist is aware of likely injury patterns and the optimum imaging modalities.
CT remains the current initial imaging modality of choice and previous concerns relating to ionizing radiation in paediatric patients may have been overplayed[4].
Despite this,
MRI is required to fully assess the extent of injuries and there should be a low threshold to proceeding to MRI in patients who have suffered high energy trauma,
even if CT imaging of the c-spine is normal.
Due to the rarity of paediatric CSI there is a paucity of data available from which robust imaging guidelines can be produced and most currently available guidelines are based on data relating to adult trauma[5].
The potentially devastating consequences of missed injuries mean that further study is required in order to minimize the risk of missing injuries while maintaining a rational use of imaging resources in this patient group[6].