Juvenile spondylolysis: a comparative analysis of CT, SPECT and MRI

Campbell, Rob; Grainger, Andrew J.; Hide, I.G.; Papastefanou, S.L.; Greenough, C G

doi:10.1007/s00256-004-0878-3

Cited by 174 publications

(111 citation statements)

References 29 publications

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“…A positive combination resulted in a Sens of 1.0. This finding corroborates those of other studies, which have offered MRI as a useful tool for early detection of spine disorders [5,6,31]. The dependence of the result on the hyperextension test may be a reflection of its use in helping to discern the presence or absence of a pars defect.…”

Section: Discussionsupporting

confidence: 90%

“…Traditionally, a SPECT/bone scan would be the next test of choice [2, 3, 10-12, 19, 22, 24]. With improved techniques, however, MRI has been proffered by numerous authors as a potential first-line test to rule out suspected disorders such as spondylolysis [5,6,31,32]. The objective of the current study was to determine the optimal imaging modality, or combination of imaging modalities, that can rule out a serious diagnosis (NPV) and be least likely to miss a serious diagnosis (Sens).…”

Section: Discussionmentioning

confidence: 99%

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Streamlining the Evaluation of Low Back Pain in Children

Auerbach

Ahn

Zgonis

et al. 2008

Clin Orthop Relat Res

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The workup of low back pain in children often results in overimaging so as not to miss organic back pain. The primary goal of this study was to identify which combination of imaging modalities provides the most sensitive and specific screening protocol for children with low back pain. Medical records from 100 consecutive patients between 2 and 18 years of age presenting with low back pain, without night pain or constitutional symptoms, were evaluated. A hyperextension test combined with a radiograph showed a negative predictive value of 0.81 and sensitivity of 0.90. The addition of a bone scan was highly effective in achieving good negative predictive value and sensitivity. Bone scans had perfect negative predictive value and sensitivity when symptom duration was less than 6 weeks. We identified a set of factors that is highly predictive for distinguishing organic back pain from mechanical back pain. Painless hyperextension combined with negative anteroposterior, lateral, and oblique lumbar radiographs and magnetic resonance images predicts mechanical back pain. For patients with nonneurologic back pain of less than 6 weeks duration, bone scan is the most useful screening test because it is accurate, accessible, inexpensive, and unlikely to require sedation.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Streamlining the Evaluation of Low Back Pain in Children

Auerbach

Ahn

Zgonis

et al. 2008

Clin Orthop Relat Res

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show abstract

“…33,43 The CT technique consists of a limited helical scan (3-mm section thickness with reconstruction to 0.75 mm) from the pedicle of the vertebra above to the pedicle of the vertebra below the level or levels of interest. On CT, fractures arising from a stress reaction may present with localized sclerosis without trabecular or cortical disruption.…”

Section: Imaging Evaluationmentioning

confidence: 99%

Imaging of Back Pain in Children

Rodriguez¹,

Poussaint²

2009

AJNR Am J Neuroradiol

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SUMMARY:While back pain presents less frequently in children than in adults, it still poses a significant clinical challenge with respect to making a firm diagnosis and developing an effective treatment plan. When children have back pain and medical attention is sought, an underlying pathology is usually suspected. Pediatric patients are evaluated, first, with a complete clinical history and examination and, second, by an imaging work-up that is based on initial findings, including the child's age and size, signs and symptoms, and suspected etiology. This article describes 1) the epidemiology of back pain in children, 2) the imaging work-up used, and 3) the correlation of imaging findings with disease entities that may cause back pain in the pediatric patient. The list of diseases giving rise to back pain is not meant to be exhaustive but rather reflective of the most commonly identified pathologies and disorders among young children and adolescents, from athletic injuries to lethal cancers.ABBREVIATIONS: ALARA ϭ as low as reasonably achievable; ESR ϭ erythrocyte sedimentation rate; FSE ϭ fast spin-echo; 18 F ϭ fluorine 18; LCH ϭ Langerhans cell histiocytosis; LDH ϭ lactate dehydrogenase; MBP ϭ mechanical back pain; PET ϭ positron-emission tomography; RFA ϭ radio-frequency ablation, SPECT ϭ single-photon emission computed tomography; STIR ϭ short tau inversion recovery; 99m Tc-MDP ϭ technetium 99m methylene diphosphonate; WHO ϭ World Health Organization B ack pain in children presents less frequently than in adults. The incidence of back pain in adults has been estimated to be as high as 60%-80% 1 ; the actual incidence of back pain in children, however, is unknown. Back pain in children presenting to the emergency department was originally thought to be an uncommon complaint, 2 reflecting significant underlying pathology compared with adults. Although recent studies have shown an increased prevalence of back pain in children, [3][4][5][6][7] relatively few patients receive medical attention.

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“…MRI is the imaging modality of choice, depicting bone marrow oedema, signal changes in adjacent muscles, and disc degeneration secondary to spondylolisthesis without the use of ionizing radiation, especially in an early stage [25][26][27]. Helical CT with multiplanar reconstruction (MPR) better detects the extent of the lesion (Fig.…”

Section: The Spinementioning

confidence: 99%

Sport injuries in the paediatric and adolescent patient: a growing problem

et al. 2009

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With an increasing number of paediatric and adolescent athletes presenting with injuries due to overuse, a greater demand is put on clinicians and radiologists to assess the specific type of injury. Repetitive forces applied to the immature skeleton cause a different type of injury than those seen in adults due to the differences in vulnerability of the musculoskeletal system, especially at the site of the growth cartilage. Intrinsic and extrinsic risk factors all play a role in the development of overuse injuries. MRI plays a key role in imaging overuse injuries due to its high potential for depicting cartilaginous and softtissue structures. Sport-specific biomechanics are described, since this knowledge is essential for adequate MRI assessment. An overview of several sport-related injuries is presented, based on anatomical location.

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Juvenile spondylolysis: a comparative analysis of CT, SPECT and MRI

Abstract: MRI can be used as an effective and reliable first-line image modality for diagnosis of juvenile spondylolysis. However, localised CT is recommended as a supplementary examination in selected cases as a baseline for assessment of healing and for evaluation of indeterminate cases.

Cited by 174 publications

References 29 publications

Streamlining the Evaluation of Low Back Pain in Children

Streamlining the Evaluation of Low Back Pain in Children

Imaging of Back Pain in Children

Sport injuries in the paediatric and adolescent patient: a growing problem

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