Low back pain in the paediatric athlete
Susannah L Roy1, Pamela C Shaw, Thomas F Beattie
1FASIC, Centre for Sport and Exercise, University of Edinburgh, Edinburgh, UK.
Summary
Pediatric low back pain (LBP) in sports clinics is common, with spondylolysis being a frequent diagnosis. Clinical assessment alone cannot reliably exclude significant radiological findings in children with back pain.
Area of Science:
- Pediatric Sports Medicine
- Musculoskeletal Radiology
- Clinical Epidemiology
Background:
- Low back pain (LBP) is a common complaint in children presenting to sports injury clinics.
- Understanding the epidemiology and clinical presentation of pediatric LBP is crucial for effective management.
Purpose of the Study:
- To investigate the epidemiological characteristics and clinical findings of children and adolescents with LBP.
- To determine the patterns of presentation, management, and outcomes in this patient group.
- To evaluate the diagnostic utility of clinical assessment and 'red flags' in identifying significant radiological findings.
Main Methods:
- Retrospective descriptive review of 174 patients aged 8-16 years.
- Data collected included epidemiological variables, historical points, and examination features, including 'red flags'.
- Findings were correlated with diagnoses from consultant radiologist-reported imaging.
Main Results:
- LBP accounted for 30% of clinic presentations.
- The median age was 14.0 years, with a near 1:1 male to female ratio.
- Rugby (males) and swimming (females) were the most prevalent sports; spondylolysis was the most common radiological diagnosis.
Conclusions:
- No consistent association was found between clinical presentation and final diagnosis.
- 'Red flags' were unreliable for including or excluding significant radiological findings.
- Clinical assessment alone is insufficient to reliably exclude significant diagnoses in pediatric patients with LBP.
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