Practical approach to the child presenting with back pain

Abstract

Back pain may be the presenting symptom of many children attending to pediatric health care settings. As such, awareness to the common etiologies of back pain in this subgroup of patients remains essential as it guides appropriate diagnosis. Although several clues may be derived from the child's history and physical examination, imaging techniques may be required to confirm the underlying diagnosis. This review summarizes the most commonly encountered causes of back pain in children and highlights diagnostic approaches that will ensure early diagnosis and intervention for a more favorable outcome.

Imperforate Hymen Presenting as Chronic Low Back Pain

“…In the pediatric textbooks 3 and reviews on pediatric back pain, 4 IH is not mentioned as a differential diagnosis of chronic low back pain. According to the gynecologic literature, 2 IH may present with abdominal pain, back pain, or difficulty with defecation or urinary retention, secondary to a mass effect from vaginal distention.…”

Back pain: A puzzle in children

“…Spondylolisthesis is the translation of one vertebral segment with respect to the vertebra below and is considered an evolution of spondylolysis …”

“…For low‐grade slippage, the treatment is similar to the conservative management of spondylolysis. In cases of high‐grade slippage, progressive slippage or persistent neurological deficits surgical intervention is indicated …”

Diagnosis and Treatment of Low Back Pain in the Pediatric Population

“…49 Benign neoplasms include osteoid osteoma, osteoblastoma, and aneurismal bone cyst. Malignancies include Ewing’s sarcoma, lymphoma, neuroblastoma, Langerhans cell histiocytosis, and metastatic disease.…”

“…Malignancies include Ewing’s sarcoma, lymphoma, neuroblastoma, Langerhans cell histiocytosis, and metastatic disease. 49 …”