Normal spinous process metaphyseal-equivalent lucency simulating infant abuse fractures

Skeletal Radiol. 2015 Oct;44(10):1519-22. doi: 10.1007/s00256-015-2184-7. Epub 2015 Jun 9.

Abstract

We report a normal radiographic finding that may be mistaken for child abuse trauma in the posterior thoracolumbar spinous processes of young infants after the first week of life. A lucency paralleling the posterior margin of the ossified spinous process is equivalent to the metaphyseal lucent bands seen normally after about a week of the child's age at the ends of long tubular bones. A similar lucency is seen just under the growth plate of vertebral bodies at that early age, giving the bone-in-bone appearance. Our index case was imaged at 3 weeks and then at 5 weeks of age, with no evidence of periosteal reaction or endosteal callus on that follow-up study, confirming the lack of fractures.

Publication types

  • Case Reports

MeSH terms

  • Child Abuse / diagnosis*
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Fractures, Bone / complications
  • Fractures, Bone / diagnostic imaging*
  • Growth Plate / diagnostic imaging*
  • Hematoma, Subdural / complications
  • Humans
  • Infant
  • Infant, Newborn
  • Lumbar Vertebrae / diagnostic imaging*
  • Skull Fractures / complications
  • Subarachnoid Hemorrhage / complications
  • Tomography, X-Ray Computed