Thoracolumbar fracture with listhesis--an uncommon manifestation of child abuse.
BACKGROUND
Thoracolumbar fracture with listhesis (FL) is an uncommon manifestation of child abuse (increasingly known as nonaccidental trauma), with only six prior reports in the literature.


OBJECTIVE
This article seeks to call attention to FL of the thoracolumbar spine in abused children and infants.


METHODS
We reviewed plain films, CT and MR images in seven new cases of FL of the thoracolumbar spine in abused children ages 6 months to 7 years, two of whom became paraplegic from their injuries.


RESULTS
Findings varied from subtle listhesis of one vertebra on another to frank vertebral dislocation, most commonly at L1/2. Paravertebral calcification was present in all but one case. In two children, thoracolumbar FL was the only radiographic sign of abuse.


CONCLUSIONS
Radiographic findings of FL of the thoracolumbar spine may be subtle and may be erroneously interpreted as due to a congenital or neoplastic cause. While other signs of child abuse should be sought, spinal injury may be the sole sign of abuse. Recognition of this entity is important to pursue the diagnosis of abuse.
Levin
Terry L
TL
Department of Radiology, Montefiore Medical Center, 111 E 210th Street, Bronx, New York, NY 10467-2490, USA. jebl@aol.com
Berdon
Walter E
WE
Cassell
Ian
I
Blitman
Netta M
NM
D002648:Child; D002649:Child Abuse / Q000175:diagnosis*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008159:Lumbar Vertebrae / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D008297:Male; D016103:Spinal Fractures / Q000150:complications* / Q000000981:diagnostic imaging; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000209:etiology*; D013904:Thoracic Vertebrae / Q000293:injuries*; D014057:Tomography, X-Ray Computed