Virtual Pediatric Hospital: Back Pain in Children: SummaryBack Pain in Children
Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Back pain in prepubertal children often has a serious underlying cause, particularly if any of the seven clinical warning signs of serious causes are present. Back pain in pubertal children often has a non-serious underlying cause, such as musculoligamentous injury from sports. However, musculoligamentous injury remains a diagnosis of exclusion and all adolescents with back pain do need proper work up if any of the seven clinical warning signs of serious causes of back pain are present. Laboratory values are often of little use in the evaluation of back pain in a child, except in cases where there is an elevated white count or sedimentation rate to suggest infection. In cases when clinical warning signs of serious causes are present, imaging is indicated in order to assist in making the diagnosis. Imaging should start with AP and lateral plain films of the spine. If these are negative, imaging should continue with a bone scan. If a lesion is found on plain film or bone scan, it should be further investigated with thin section CT. If plain film and bone scan are negative, MRI may be of use.
All imaging of back pain in children should be done by a radiologist after consultation with the radiologist. In cases were there is a suspected serious underlying cause of back pain, early involvement of an orthopedist is also recommended.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.