title: Normal spinous process metaphyseal-equivalent lucency simulating infant abuse fractures.
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.
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA, alan.oestreich@cchmc.org.
authors.forename: Alan E
authors.initials: AE
authors.lastname: Oestreich
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Anton
mesh_terms: D002649:Child Abuse / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000150:complications / Q000000981:diagnostic imaging*; D006132:Growth Plate / Q000000981:diagnostic imaging*; D006408:Hematoma, Subdural / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D012887:Skull Fractures / Q000150:complications; D013345:Subarachnoid Hemorrhage / Q000150:complications; D014057:Tomography, X-Ray Computed