Radiological evaluation of the Tuffier’s line in pediatric patients

Aim: Tuffier’s Line (Intercristal line) is defined as the line connecting the highest points of both iliac crests which generally passes through either the body of the L4 vertebra or the intervertebral space between L4-5 vertebrae. In this study, we assessed the radiological evaluation of the level of Tuffier’s line with changes in age and gender in pediatric population. Material and Method: In this study, standing anteroposterior lumbar radiographs of 519 patients aged 16 and younger were analyzed retrospectively. Notation was made as to the intersection of this line with one of the following structures: L4 vertebral body, L4 inferior endplate, L4–L5 disc space, L5 superior endplate, L5 vertebral body, L5 inferior endplate, L5-S1 disc space. Patients’ gender, age and vertebral level of the Tuffier’s line are recorded. Data is analyzed with chi-square test. Results: There were 315 male and 204 female patients.There were no significant difference between females and males on the level of Tuffier’s line (p=0.102). In both male and female groups Tuffier’s line tended to pass through the L5 vertebral body, respectively 44.8 % and 46.1 %. There was a significant difference between age groups on the level of Tuffier’s line (p<0.001). Tuffier’s line were significantly increased with ascending ages. Discussion: This study clearly demonstrated that the Tuffier’s line were in a similar position in females compared to males and also Tuffier’s line were in a significantly lower position in younger age groups.Tuffier’s line were significantly increase with ascending ages in pediatric patients.