Vertebral body fractures in child abuse. Radiologic-histopathologic correlates.
OBJECTIVE
Vertebral injuries are rarely reported sequelae of child abuse, and little is known concerning the mechanisms of injury and healing. A preliminary investigation of these issues included correlating radiologic and histologic findings in children with vertebral injuries who died of complications relating to physical abuse.


METHODS
Ten vertebral body fractures from four abused infants and young children were studied radiologically and histopathologically.


RESULTS
Infants ranged in age from 7 to 36 months (mean, 21 months). Three patients died of associated head injuries. One child died after abandonment. There were three pure vertebral body compression fractures, two superior end-plate fractures without compression deformity, and five anterosuperior end-plate fractures with associated compression deformity. Vertebral compression was generally mild (less than 25%). Typically, end-plate injuries were manifest histologically by extension of the fracture through the medullary trabeculae into the proliferative zone of the superior end plate. The resultant pattern was analogous to that described in a previous study, and could potentially result in a growth disturbance at the vertebral end plate.


CONCLUSIONS
Observed radiologic patterns and histologic correlates may help explain previously described findings, such as vertebral notching, in abused infants.
Kleinman
P K
PK
Department of Radiology, University of Massachusetts Medical Center, Worcester 01655.
Marks
S C
SC
D002649:Child Abuse / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries* / Q000473:pathology