Role of CT and MRI in Evaluation of Adolescent Painful Scoliosis

Background Data: Osteoid osteoma is the most common cause of adolescent painful scoliosis. Although, plain radiography, bone scintigraphy and CT, have important role in its diagnosis, these modalities cause radiation hazards for the patients. MRI is safe, free from ionizing radiation, accurate in evaluation of a young patient with back-pain and scoliosis.Study Design: This is a prospective study conducted on 12 young patients, presented clinically with a painful scoliosis and referred for CT & MRI examination. Aim: to evaluate helical CT and MRI findings in adolescent painful scoliosis.Patients and methods: This study was conducted on 12 adolescent patients, 7 males and 5 females with an age range of 8–18 years, presented with painful scoliosis during the period from May 2011 to April 2014. CT and MRI are done for all patients. Surgery was performed in 11 patients. Results: Nine patients were diagnosed as osteoid osteoma, two patients diagnosed as osteoblastoma & one patient diagnosed as aneurysmal bone cyst. On CT, a nidus was identified in 9 patients and reactive sclerosis was seen in 10 patients. MRI demonstrated the nidus in 8 patients and unilateral neural arch oedema with anterior extension to involve the ipsilateral posterolateral vertebral body in 9 patients. MRI features were correlated with CT. Conclusion: The presence of unilateral neural arch oedema extending to involve ipsilateralposterolateral vertebral body in MRI evaluation of adolescent painful scoliosis, raises the possibility of spinal osteoid osteoma, so, CT is recommended to detect the presence of a nidus. (2015ESJ 069)