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Evaluating the child with back pain

P D Sponseller1

  • 1Johns Hopkins Hospital, Baltimore, Maryland, USA.

American Family Physician
|November 1, 1996
PubMed
Summary
This summary is machine-generated.

Identifying serious low back pain in children involves understanding common causes like spondylolysis and Scheuermann disease. Prompt evaluation of pain characteristics and warning signs is crucial for accurate diagnosis and treatment.

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Area of Science:

  • Pediatric Orthopedics
  • Musculoskeletal Disorders

Background:

  • Low back pain is a common complaint in children.
  • Serious causes require prompt identification to prevent long-term complications.

Purpose of the Study:

  • To outline the common and rare causes of serious low back pain in children.
  • To guide clinicians in the diagnostic approach and recognition of red flags.

Main Methods:

  • Review of common pediatric low back pain etiologies.
  • Emphasis on history taking, including pain characteristics and exacerbating factors.
  • Guidance on physical examination components: gait, alignment, flexibility, strength, reflexes, and pain localization.

Main Results:

  • Common causes include spondylolysis, Scheuermann disease, and musculoligamentous injury.

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  • Red flags for serious pathology include constant pain in young children, nocturnal pain, fever, and neurological deficits.
  • Specific diagnostic clues: lumbosacral junction pain suggests spondylolysis/spondylolisthesis; vertebral abnormalities suggest Scheuermann disease.

    • Conclusions:

    • A thorough history and physical examination are essential for evaluating pediatric low back pain.
    • Recognizing red flags and understanding common etiologies aids in timely diagnosis and management of serious conditions.