Imaging Assessment of the Pediatric Spine: Selected Topics

  • Sergio Lopes Viana
  • Maria Custódia Machado Ribeiro
  • Bruno Beber Machado


Several diseases may affect the spine of children and adolescents, some of them inherent to skeletally immature patients, such as juvenile idiopathic arthritis, “idiopathic” pediatric intervertebral disc calcification, and Scheuermann disease, while others are not specific of the pediatric age group but present peculiarities when children are affected, such as spondylolysis and spinal infection. Awareness of the imaging appearance of these conditions is paramount to the differential diagnosis and to guide therapeutic decision-making. Some other musculoskeletal disorders that present spinal involvement in children are discussed elsewhere in this book and are not included in this chapter.


Imaging Joints Radiology Children Adolescents Pediatrics Radiographs X-rays Ultrasonography Computed tomography Magnetic resonance imaging Spine Juvenile idiopathic arthritis Arthritis Synovitis Spondylodiscitis Tuberculosis Pott disease Spinal infection Spondylolysis Scheuermann disease Disc calcification 

Recommended Reading

  1. 1.
    Arbelaez A, Restrepo F, Castillo M. Spinal infections: clinical and imaging features. Top Magn Reson Imaging. 2014;23:303–14.CrossRefGoogle Scholar
  2. 2.
    Boody BS, Tarazona DA, Vaccaro AR. Evaluation and management of pyogenic and tubercular spine infections. Curr Rev Musculoskelet Med. 2018;11:643–52.CrossRefGoogle Scholar
  3. 3.
    Campbell RS, Grainger AJ, Hide IG, Papastefanou S, Greenough CG. Juvenile spondylolysis: a comparative analysis of CT, SPECT and MRI. Skeletal Radiol. 2005;34:63–73.CrossRefGoogle Scholar
  4. 4.
    Du JJ, Chen YF, Peng Y, Li XJ, Ma W. Calcification of the intervertebral disc and ossification of posterior longitudinal ligament in children. BMC Musculoskelet Disord. 2018;
  5. 5.
    Endén K, Laiho K, Kautiainen H, Arkela-Kautiainen M, Belt E, Kauppi M. Subaxial cervical vertebrae in patients with juvenile idiopathic arthritis – something special? Joint Bone Spine. 2009;76:519–23.CrossRefGoogle Scholar
  6. 6.
    Faingold R, Saigal G, Azouz EM, Morales A, Albuquerque PA. Imaging of low back pain in children and adolescents. Semin Ultrasound CT MR. 2004;25:490–505.CrossRefGoogle Scholar
  7. 7.
    Frank G, Mahoney HM, Eppes SC. Musculoskeletal infections in children. Pediatr Clin North Am. 2005;52:1083–106.CrossRefGoogle Scholar
  8. 8.
    Gokce E, Beyhan M. Radiological imaging findings of Scheuermann disease. World J Radiol. 2016;8:895–901.CrossRefGoogle Scholar
  9. 9.
    Hong SH, Choi JY, Lee JW, Kim NR, Choi JA, Kang HS. MR imaging assessment of the spine: infection or an imitation? Radiographics. 2009;29:599–612.CrossRefGoogle Scholar
  10. 10.
    Hospach T, Maier J, Müller-Abt P, Patel A, Horneff G, von Kalle T. Cervical spine involvement in patients with juvenile idiopathic arthritis – MRI follow-up study. Pediatr Rheumatol Online J. 2014;
  11. 11.
    Johnson K. Imaging of juvenile idiopathic arthritis. Pediatr Radiol. 2006;36:743–58.CrossRefGoogle Scholar
  12. 12.
    Kapetanos GA, Hantzidis PT, Anagnostidis KS, Kirkos JM. Thoracic cord compression caused by disk herniation in Scheuermann’s disease: a case report and review of the literature. Eur Spine J. 2006;15(Suppl 5):553–8.CrossRefGoogle Scholar
  13. 13.
    Kerssemakers SP, Fotiadou AN, de Jonge MC, Karantanas AH, Maas M. Sport injuries in the paediatric and adolescent patient: a growing problem. Pediatr Radiol. 2009;39:471–84.CrossRefGoogle Scholar
  14. 14.
    Kilborn T, Janse van Rensburg P, Candy S. Pediatric and adult spinal tuberculosis: imaging and pathophysiology. Neuroimaging Clin N Am. 2015;25:209–31.CrossRefGoogle Scholar
  15. 15.
    Kjellberg H, Pavlou I. Changes in the cervical spine of children with juvenile idiopathic arthritis evaluated with lateral cephalometric radiographs. Angle Orthod. 2011;81:447–52.CrossRefGoogle Scholar
  16. 16.
    Klju``evšek D, Emeršič N, Toplak N, Avčin T. Clinical and MRI outcome of cervical spine lesions in children with juvenile idiopathic arthritis treated with anti-TNFα drugs early in disease course. Pediatr Rheumatol Online J. 2017;
  17. 17.
    Kumar Y, Gupta N, Chhabra A, Fukuda T, Soni N, Hayashi D. Magnetic resonance imaging of bacterial and tuberculous spondylodiscitis with associated complications and non-infectious spinal pathology mimicking infections: a pictorial review. BMC Musculoskelet Disord. 2017;
  18. 18.
    Laine JC, Kaiser SP, Diab M. High-risk pediatric orthopedic pitfalls. Emerg Med Clin North Am. 2010;28:85–102.CrossRefGoogle Scholar
  19. 19.
    Liu N, Guo X, Chen Z, Qi Q, Li W, Guo Z, et al. Radiological signs of Scheuermann disease and low back pain: retrospective categorization of 188 hospital staff members with 6-year follow-up. Spine (Phila Pa 1976). 2014;39:1666–75.CrossRefGoogle Scholar
  20. 20.
    Liu W, Tang C, Liu L, Zhu QS, Huang LF. Cervical intervertebral disc calcification with extreme lateral herniation in a child: T2-weighted signal intensity of the involved disc can be restored to normal. Childs Nerv Syst. 2016;32:749–52.CrossRefGoogle Scholar
  21. 21.
    Lonner BS, Toombs CS, Mechlin M, Ciavarra G, Shah SA, Samdani AF, et al. MRI screening in operative Scheuermann kyphosis: is it necessary? Spine Deform. 2017;5:124–33.CrossRefGoogle Scholar
  22. 22.
    Prodi E, Grassi R, Iacobellis F, Cianfoni A. Imaging in spondylodiskitis. Magn Reson Imaging Clin N Am. 2016;24:581–600.CrossRefGoogle Scholar
  23. 23.
    Pruthi S, Thapa MM. Infectious and inflammatory disorders. Magn Reson Imaging Clin N Am. 2009;17:423–38.CrossRefGoogle Scholar
  24. 24.
    Ranson M. Imaging of pediatric musculoskeletal infection. Semin Musculoskelet Radiol. 2009;13:277–99.CrossRefGoogle Scholar
  25. 25.
    Rush JK, Astur N, Scott S, Kelly DM, Sawyer JR, Warner WC Jr. Use of magnetic resonance imaging in the evaluation of spondylolysis. J Pediatr Orthop. 2015;35:271–5.PubMedGoogle Scholar
  26. 26.
    Shikhare SN, Singh DR, Shimpi TR, Peh WC. Tuberculous osteomyelitis and spondylodiscitis. Semin Musculoskelet Radiol. 2011;15:446–58.CrossRefGoogle Scholar
  27. 27.
    Sofka CM, Bogner E. Imaging of juvenile rheumatoid arthritis. HSS J. 2008;4:71–3.CrossRefGoogle Scholar
  28. 28.
    Sudoł-Szopińska I, Grochowska E, Gietka P, Płaza M, Pracoń G, Saied F, et al. Imaging of juvenile idiopathic arthritis. Part II: ultrasonography and MRI. J Ultrason. 2016;16:237–51.CrossRefGoogle Scholar
  29. 29.
    Teo HE, Peh WC. Skeletal tuberculosis in children. Pediatr Radiol. 2004;34:853–60.CrossRefGoogle Scholar
  30. 30.
    Viana SL, Viana MA, de Alencar EL. Atypical, unusual, and misleading imaging presentations of spondylolysis. Skeletal Radiol. 2015;44:1253–62.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sergio Lopes Viana
    • 1
  • Maria Custódia Machado Ribeiro
    • 2
  • Bruno Beber Machado
    • 3
  1. 1.Hospital da Criança de Brasília José Alencar, Hospital Ortopédico e Medicina Especializada (HOME) and Diagnóstico Clínica de Imagens MédicasBrasíliaBrazil
  2. 2.Hospital da Criança de Brasília José AlencarBrasíliaBrazil
  3. 3.Gastren Clínica Médica e Radiológica (Iúna-ES), Clínica Radiológica Med Imagem, Clínica Radiológica Radial, Santa Casa de Misericórdia and Unimed Sul CapixabaCachoeiro de ItapemirimBrazil

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