Comparative analysis of the diagnostic effectiveness of radiography and magnetic resonance imaging in uncomplicated spinal compression fractures in children

DOI: 10.47026/2413-4864-2026-3-12-22

UDC: 616-073.7:616.711-001.5-053.2
BBC: 53.6+54.58

Ismiev D.A., Akhadov T.A., Melnikov I.A., Meshcheryakov S.V., Porokhina E.A.

Comparative analysis of the diagnostic effectiveness of radiography and magnetic resonance imaging in uncomplicated spinal compression fractures in children

Keywords: compression fracture, the spine, radiography, magnetic resonance imaging, wedge index

Compression fractures of vertebral bodies in children are a clinically significant pathology. Though radiography is traditionally the first-line method in diagnosis, its informative value is often insufficient due to projections superimposition and anatomical features of the growing child's skeleton. Magnetic resonance imaging has a high soft tissue contrast and makes it possible to detect bone marrow edema without radiation exposure.

The aim of the study was to conduct a comparative analysis of routine radiography and magnetic resonance imaging data in the acute period of uncomplicated spinal injury in children and adolescents in order to develop an optimized diagnostic algorithm.

Materials and methods. 47 patients (average age 10.7±3.4 years) with suspected thoracic compression fracture were examined. A comparative assessment of vertebral bodies deformation was carried out by calculating the wedge index according to radiography and magnetic resonance imaging. Spearman correlation analysis and Bland–Altman analysis were also performed.

Results. According to magnetic resonance imaging, 67 vertebral injuries were diagnosed in 26 patients. Multiple fractures occurred in 61.5% of cases. Routine spondylography showed low diagnostic effectiveness. The sensitivity was 32.3%, the specificity was 42.1%, the overall accuracy was 35.8%. Marked underdiagnosis was noted, as well as cases of overdiagnosis. When comparing the wedge index values obtained by radiography and magnetic resonance imaging, a strong direct correlation was found.

Conclusions. Classical radiography has a low diagnostic effectiveness in the diagnosis of compression fractures of the vertebral bodies in children. Magnetic resonance imaging makes it possible to objectively visualize structural changes, including trabecular edema, and measurement of the wedge index is as accurate as roentgenometry in quantifying deformity. This justifies the feasibility of integrating magnetic resonance imaging into a routine diagnostic algorithm to minimize unjustified therapeutic measures and to optimize patient management tactics.

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About authors

Ismiev Dzheihun A.: Post-Graduate Student, Department of Diagnostic Radiology, Research Institute of Emergency Pediatric Surgery and Traumatology – Dr. Roshal’s Clinic, Russia, Moscow (IsmievDA@zdrav.mos.ru; ORCID: https://orcid.org/0000-0003-4283-3505)

Akhadov Tolibdzhon A.: Doctor of Medical Sciences, Professor, Head of the Department of Diagnostic Radiology, Research Institute of Emergency Pediatric Surgery and Traumatology – Dr. Roshal’s Clinic, Russia, Moscow (AkhadovTA@zdrav.mos.ru; ORCID: https://orcid.org/0000-0002-3235-8854)

Melnikov Ilia A.: Candidate of Medical Sciences, Head of the Department of Magnetic Resonance and Computed Tomography, Radiologist, Research Institute of Emergency Pediatric Surgery and Traumatology – Dr. Roshal’s Clinic, Russia, Moscow (MelnikovIA3@zdrav.mos.ru; ORCID: https://orcid.org/0000-0002-2910-3711)

Meshcheryakov Semen V.: Candidate of Medical Sciences, Deputy Director for Clinical Affairs – Chief Medical Officer, Neurosurgeon, Pediatric Surgeon, Research Institute of Emergency Pediatric Surgery and Traumatology – Dr. Roshal’s Clinic, Russia, Moscow (MescheryakovSV@zdrav.mos.ru; ORCID: https://orcid.org/0000-0003-3001-4628)

Porokhina Ekaterina A.: Pediatric Surgeon, Research Institute of Emergency Pediatric Surgery and Traumatology – Dr. Roshal’s Clinic, Russia, Moscow (PorokhinaEA1@zdrav.mos.ru; ORCID: https://orcid.org/0000-0002-2396-8992)

Article link

Ismiev D.A., Akhadov T.A., Melnikov I.A., Meshcheryakov S.V., Porokhina E.A. Comparative analysis of the diagnostic effectiveness of radiography and magnetic resonance imaging in uncomplicated spinal compression fractures in children [Electronic resource] // Acta medica Eurasica. – 2026. – №3. P. 12-22. – URL: https://acta-medica-eurasica.ru/en/single/2026/3/2/. DOI: 10.47026/2413-4864-2026-3-12-22.

Single article

Ismiev D.A., Akhadov T.A., Melnikov I.A., Meshcheryakov S.V., Porokhina E.A.