# Spectrum of neuropathic skeletal injuries in children: a pictorial essay

## TL;DR

This essay explores the imaging features of neuropathic skeletal injuries in children, highlighting their progression and treatment to prevent permanent deformities.

## Contribution

The essay fills a literature gap by presenting a comprehensive overview of pediatric neuropathic skeletal injuries using modern imaging techniques.

## Key findings

- Neuropathic skeletal injuries in children show features like arthropathy, avascular necrosis, and joint dislocation.
- Imaging techniques such as radiography, MRI, and CT are essential for assessing these injuries.
- Unrecognized injuries can lead to permanent deformities and reduced quality of life.

## Abstract

Neuropathic skeletal injuries in children are common manifestations of conditions associated with sensory impairment. The underlying aetiologies may be rare entities such as congenital insensitivity to pain or more prevalent disorders such as spinal dysraphisms. While the imaging manifestations of such injuries have been described in adults, the paediatric literature is sparse, primarily comprising case reports and case series with insufficient imaging data. Characteristic imaging findings in patients with neuropathic skeletal injuries include neuropathic arthropathy, avascular necrosis, joint dislocation, repeated fractures with exuberant callus formation, epiphyseal separation, and acro-osteolysis. Conventional radiography, MRI, and CT all contribute to the comprehensive assessment of paediatric neuropathic lesions. This pictorial essay illustrates the spectrum of imaging findings in children with neuropathic skeletal injuries of varying aetiologies as well as their natural evolution and treatment.

This essay addresses a critical gap in the literature on paediatric neuropathic skeletal injuries, providing a detailed overview of their imaging manifestations, natural progression, and relevant treatment strategies, through contemporary imaging techniques such as radiography, MRI, and CT.

Unrecognised neuropathic skeletal injuries cause progressive permanent deformities, impacting quality of life.Suspect neuropathic arthropathy in children with sensory loss presenting with painless inflamed joints.Neuropathic injuries may be mistaken for osteomyelitis, septic arthritis, or other disorders.

Unrecognised neuropathic skeletal injuries cause progressive permanent deformities, impacting quality of life.

Suspect neuropathic arthropathy in children with sensory loss presenting with painless inflamed joints.

Neuropathic injuries may be mistaken for osteomyelitis, septic arthritis, or other disorders.