Infantile cervical ligament edema can typically be seen when infants have suffered accidental or abusive head and neck trauma. The finding is best seen on sagittal STIR images.
The posterior ligamentous complex refers to the ligamentum flavum and interspinous ligaments. The anterior and posterior longitudinal ligaments, ligamentum flavum, and apical ligament are all seen on cervical MR studies.
The infant will undergo neck imaging as part of a trauma evaluation.
In a group of homicide victims who were children under the age of 2 years, 21% of those who had spinal cord injuries had cervical ligamentous injury as well 1.
- STIR: ligaments are hyperintense
Treatment and prognosis
Neck MRI is indicated in severe infantile head and neck injury. It is debatable whether ligamentous neck injury is suggestive of non-accidental injury 2-4.
- 1. Brennan LK, Rubin D, Christian CW, Duhaime AC, Mirchandani HG, Rorke-Adams LB. Neck injuries in young pediatric homicide victims. Journal of neurosurgery. Pediatrics. 3 (3): 232-9
- 2. Choudhary AK, Ishak R, Zacharia TT, Dias MS. Imaging of spinal injury in abusive head trauma: a retrospective study. Pediatric radiology. 44 (9): 1130-40
- 3. Kadom N, Khademian Z, Vezina G, Shalaby-Rana E, Rice A, Hinds T. Usefulness of MRI detection of cervical spine and brain injuries in the evaluation of abusive head trauma. Pediatric radiology. 44 (7): 839-48.
- 4. Baerg J, Thirumoorthi A, Vannix R, Taha A, Young A, Zouros A. Cervical spine imaging for young children with inflicted trauma: Expanding the injury pattern. Journal of pediatric surgery. 52 (5): 816-821