Also, intrinsic fluid-fluid levels and associated soft-tissue abnormalities are better demonstrated on MRI. Apophyseal ring fractures are also well evaluated on CT [31]. CT with contrast can be considered when infection and abscess are suspected and MRI is contraindicated or not feasible. Myelography and Postmyelography Computed Tomography Spine The indication for myelography and postmyelography CT is narrow and limited because of its invasiveness and limited diagnostic yield. Myelography and postmyelography CT can be considered in conditions where intraspinal pathology is suspected and MRI is either contraindicated or will be significantly limited by existing hardware. Discussion of Imaging Modalities by Variant Variant 1: Child. Back pain with none of the following clinical red flags: constant pain, night pain, radicular pain, pain lasting >4 weeks, abnormal neurologic examination. Initial imaging evaluation. Radiographs There is little evidence that radiographic evaluation of the region of interest in acute uncomplicated back pain without an associated traumatic event is indicated [8,9,11,12]. MRI Spine MRI is not indicated in back pain without clinical red flags present [1,4,5]. If an inflammatory, infectious, or neoplastic process is suggested from initial clinical or laboratory evaluation, MRI without and with contrast of the complete spine is the suggested imaging modality in further imaging evaluation [8,27,28]. If contrast is administered, precontrast images are helpful to assess enhancement. There is little use for performing an MRI with contrast only. CT Spine CT is not indicated for evaluation of patients with back pain and no clinical red flags. If an inflammatory, infectious, or neoplastic process is suggested from initial clinical or laboratory evaluation and MRI cannot be obtained, a CT spine with contrast targeted to the area of interest may be indicated. CT spine without and with contrast is not indicated for evaluation of patients with back pain and no red flags.
Back Pain Child PCAs. Also, intrinsic fluid-fluid levels and associated soft-tissue abnormalities are better demonstrated on MRI. Apophyseal ring fractures are also well evaluated on CT [31]. CT with contrast can be considered when infection and abscess are suspected and MRI is contraindicated or not feasible. Myelography and Postmyelography Computed Tomography Spine The indication for myelography and postmyelography CT is narrow and limited because of its invasiveness and limited diagnostic yield. Myelography and postmyelography CT can be considered in conditions where intraspinal pathology is suspected and MRI is either contraindicated or will be significantly limited by existing hardware. Discussion of Imaging Modalities by Variant Variant 1: Child. Back pain with none of the following clinical red flags: constant pain, night pain, radicular pain, pain lasting >4 weeks, abnormal neurologic examination. Initial imaging evaluation. Radiographs There is little evidence that radiographic evaluation of the region of interest in acute uncomplicated back pain without an associated traumatic event is indicated [8,9,11,12]. MRI Spine MRI is not indicated in back pain without clinical red flags present [1,4,5]. If an inflammatory, infectious, or neoplastic process is suggested from initial clinical or laboratory evaluation, MRI without and with contrast of the complete spine is the suggested imaging modality in further imaging evaluation [8,27,28]. If contrast is administered, precontrast images are helpful to assess enhancement. There is little use for performing an MRI with contrast only. CT Spine CT is not indicated for evaluation of patients with back pain and no clinical red flags. If an inflammatory, infectious, or neoplastic process is suggested from initial clinical or laboratory evaluation and MRI cannot be obtained, a CT spine with contrast targeted to the area of interest may be indicated. CT spine without and with contrast is not indicated for evaluation of patients with back pain and no red flags.