injuries poisoning
Spinal Cord Injury in Children
Diagnosis of Spinal Cord Injury in Children
X-rays (cross-table lateral view, anteroposterior view, and open-mouth odontoid view) Usually CT, particularly for bony or ligamentous injury MRI to confirm injury site and level within the spinal cord Spinal cord injury should be suspected in any child who has been in a motor vehicle crash, has fallen from a height≥3 meters, or has had a submersion injury. Spinal cord injury without evidence of radiologic abnormality (SCIWORA) is suspected in children who have even transient symptoms of neurologic dysfunction or lancinating pains down the spine or extremities and a mechanism of injury compatible with spinal cord injury. SCIWORA is a common phenomenon originally described in the 1980s, when there was a lack of MRI scanners capable of detecting the causative radiologic abnormalities. The term SCIWORA is less commonly used currently because MRI scanners are more readily available in hospitals in the United States and can identify the causative radiologic abnormalities. Depending on local imaging resource availability, imaging usually begins with x-rays, including cross-table lateral, anteroposterior, and open-mouth odontoid views. If fracture, dislocation, or subluxation is suspected based on x-ray findings or a very high-risk mechanism of injury, CT is usually done. MRI is usually done with any of the following: Spinal cord injury is suspected based on x-ray or CT Spinal cord injury is suggested by neurologic deficits on examination Spinal cord injury is suggested by a history of even transient neurologic deficits 