MRI can confirm and further characterize abnormalities demonstrated on radiographs. MRI is especially useful in evaluation of children with positive neurologic findings. An imaging algorithm has been proposed that includes only MRI in the imaging evaluation of children with positive neurologic findings [4]. If contrast is administered, precontrast images are helpful to assess enhancement. Findings on spine radiographs such as disc-space narrowing, endplate irregularity, bone destruction, or widening of the spinal canal suggest an inflammatory, infectious, or neoplastic process [7,8]. MRI of the total spine without and with contrast is helpful in the evaluation of back pain in children with clinical or imaging evidence of infection, inflammation, or tumor [8,13,33]. There is little use for performing an MRI with contrast only. MRI of the spine in the clinical setting of back pain should always be performed with fat-saturated imaging techniques, especially following the administration of contrast. CT Spine Fractures and bone lesions may be suggested on radiographs of the spine. These entities may be better delineated and confirmed on targeted noncontrast CT [7,15]. CT has been found to be complementary to bone scan in evaluation of spondylolysis [4,30]. CT with contrast should be considered only when MRI is contraindicated or not feasible. Performing CT both without and with contrast is not usually indicated. In the circumstance of determining the presence of calcifications, limited noncontrast images could be obtained through the area of interest. Bone Scan Whole Body with SPECT or SPECT/CT Complete Spine Tc-99m bone scan may be a useful screening tool in children with back pain and no specific neurologic findings on physical examination [4]. Bone scan can confirm the presence of an abnormality suggested on radiographs, and because of the whole-body technique it has the ability to demonstrate additional osseous abnormalities (multifocality) as regions of increased radiotracer uptake [31,36]
Back Pain Child PCAs. MRI can confirm and further characterize abnormalities demonstrated on radiographs. MRI is especially useful in evaluation of children with positive neurologic findings. An imaging algorithm has been proposed that includes only MRI in the imaging evaluation of children with positive neurologic findings [4]. If contrast is administered, precontrast images are helpful to assess enhancement. Findings on spine radiographs such as disc-space narrowing, endplate irregularity, bone destruction, or widening of the spinal canal suggest an inflammatory, infectious, or neoplastic process [7,8]. MRI of the total spine without and with contrast is helpful in the evaluation of back pain in children with clinical or imaging evidence of infection, inflammation, or tumor [8,13,33]. There is little use for performing an MRI with contrast only. MRI of the spine in the clinical setting of back pain should always be performed with fat-saturated imaging techniques, especially following the administration of contrast. CT Spine Fractures and bone lesions may be suggested on radiographs of the spine. These entities may be better delineated and confirmed on targeted noncontrast CT [7,15]. CT has been found to be complementary to bone scan in evaluation of spondylolysis [4,30]. CT with contrast should be considered only when MRI is contraindicated or not feasible. Performing CT both without and with contrast is not usually indicated. In the circumstance of determining the presence of calcifications, limited noncontrast images could be obtained through the area of interest. Bone Scan Whole Body with SPECT or SPECT/CT Complete Spine Tc-99m bone scan may be a useful screening tool in children with back pain and no specific neurologic findings on physical examination [4]. Bone scan can confirm the presence of an abnormality suggested on radiographs, and because of the whole-body technique it has the ability to demonstrate additional osseous abnormalities (multifocality) as regions of increased radiotracer uptake [31,36]