Diagnosis and Treatment of Low Back Pain in the Pediatric Population

Taxter, Alysha J.; Chauvin, Nancy A.; Weiss, Pamela F.

doi:10.3810/psm.2014.02.2052

Cited by 26 publications

(22 citation statements)

References 81 publications

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“…In some patients, MRI might have been performed to rule out sacroiliitis rather than to confirm it, but this is hazardous since only about half of pediatric patients presenting with inflammatory back pain who ultimately are diagnosed with spondyloarthritis have any MRI abnormalities [12]. A thorough history and physical exam is important and may be helpful for correct diagnosis [11,21,22]. The presence of hip arthritis and enthesitis, characterized as incidental findings here, in patients suspected of JSpA may in fact be closely linked to the primary disease, considering that patients with JSpA more often present with peripheral arthritis and enthesitis, while symptoms involving the spine and SI joints often occur later [12,23].…”

Section: Discussionmentioning

confidence: 99%

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Common incidental findings on sacroiliac joint MRI in children clinically suspected of juvenile spondyloarthritis

Schiettecatte

Jaremko

Sudoł‐Szopińska

et al. 2020

European Journal of Radiology Open

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A B S T R A C TPurpose: To determine the prevalence of incidental findings on sacroiliac (SI) joint MRI in children clinically suspected of Juvenile Spondyloarthritis (JSpA). Methods: In this retrospective multi-center study of 540 children clinically suspected of JSpA who underwent MRI of SI joints from February 2012 to May 2018, the prevalence of sacroiliitis and other incidental findings was recorded. Results: In 106/540 (20 %) children MRI features of sacroiliitis were present. In 228 (42 %) patients MRI showed at least one incidental finding other than sacroiliitis. A total of 271 abnormal findings were reported. The most frequent incidental findings were at lumbosacral spine (158 patients, 29 %) and hip (43 patients, 8 %). The most common incidental finding was axial degenerative changes, seen in 94 patients (17 %). Other less frequent pathologies were: simple (bone) cyst in 15 (2,8 %) patients; enthesitis/tendinitis in 16 (3 %) patients; nonspecific focal bone marrow edema (BME) away from SI joints in 10 (1,9 %) patients; ovarian cysts in 7 (1,3 %) patients; BME in the course of chronic recurrent multifocal osteomyelitis (CRMO) in 4 (0,7 %) patients; muscle pathology in 4 (0,7%) patients; benign tumors in 3 (0,6 %) patients; (old) fractures in 3 (0,6 %) patients; bony apophyseal avulsion in 2 (0,4 %) patients and malignant tumors in 2 (0,4 %) patients. Conclusion: Incidental findings are common on MRI of the SI joints in children clinically suspected of JSpA, particularly at the lumbar spine and hips. They are seen even more frequently than sacroiliitis and can be relevant, as some will have clinical significance or require treatment.

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Section: Discussionmentioning

confidence: 99%

“…In total 540 pediatric patients were included, 267 (51 %) boys and 264 (49 %) girls with a median age of 14,8 and a mean age of 14,4 (range 0, [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]1). 180 consecutive patients were included in every single institution.…”

Section: Study Groupmentioning

confidence: 99%

Common incidental findings on sacroiliac joint MRI in children clinically suspected of juvenile spondyloarthritis

Schiettecatte

Jaremko

Sudoł‐Szopińska

et al. 2020

European Journal of Radiology Open

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“…Bunlar arasında; malignite, disk herniyasyonu ve inflamatuvar durumlar araştırılmalıdır. [13] Kemik lezyonlarında ağrı lokalizasyonu belli iken, nöromusküler ve inflamatuvar nedenli ağrılarda bu net değildir. Bel ağrısı şikayeti olan hastalar daha çok mekanik ağrıdan söz ederken; sinir basısı nedeni ile şikayet eden hastalar daha çok bacak ağrısını öne sürerler.…”

Section: Kli̇ni̇k Yaklaşimunclassified

“…[47] Yapılan çalışmalarda, çocukluk ve ergenlik döneminde %1-2 arasında olduğu [47,48] ve kızlarda, erkeklerden daha sık görüldüğü bildirilmiştir. [13] Tedavide multidisipliner yaklaşımlar uygulanır. Farmakolojik tedavilere ek olarak; bilişsel davranış tedavisi, hasta eğitimi, fizik tedavi ajanları ve egzersiz programlarından yararlanılır.…”

Section: Juvenil Primer Fibromiyalji Sendromuunclassified

“…Omurga, fibrokartilajinöz disk ve sakroiliak eklemler, enfeksiyöz ajanlara duyarlı yapılardır. [13] Spinal tüberküloza (Pott hastalığı) neden olan Mycobacterium tuberculosis, omurlara zarar verebileceği gibi; hematojen yolla, spinal korda, diske ve bu yapıları çevreleyen dokulara da yayılabilir. Çocuklarda, sıklıkla alt torasik ve lomber omurlar tutulum gösterir.…”

Section: Enfeksiyöz Nedenlerunclassified

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Çocuklarda bel ağrısı

Balikci¹,

Bezer²

2015

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Çocuklarda bel ağrısı; enfeksiyon, mekanik nedenler, neoplazi veya inflamasyon gibi nedenlere bağlı gelişir. [6] Obezite ve sportif aktivitelerin artması sonucu, kas iskelet sistemi kaynaklı sırt ağrıları artarken; nonorganik nedenler arasında, psikososyal problemler ve aile öyküsü sayılabilir. [6-8] Ayrıca, uzun süre televizyon seyretmek, bilgisayar başında oturmak ve sedanter yaşam öyküsü de çocuklar arasında bel ağrısına neden olabilecek faktörler arasındadır. [10]

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Musculoskeletal Low Back Pain in School-aged Children

2017

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ow back pain (LBP) in school-aged children is a common occurrence; nevertheless, it is often underappreciated. 1 The prevalence of LBP rises with age: 1% at age 7 years, 6% at age 10 years, and 18% at ages 14 to 16 years. 2 By age 18 years, the lifetime prevalence rates of LBP approach those documented in adults, with an estimated yearly prevalence of 20% and a lifetime prevalence of 75%. 3 More than 7% of adolescents experiencing LBP will seek medical attention. 1 The effect of LBP on this population can be considerable and may significantly restrict instrumental activities of daily living for this population, such as attendance at school and gym or sports participation. 4 Low back pain in this age group is a significant risk factor for developing LBP as an adult. 5 Several potential risk factors for developing LBP in schoolaged children have been investigated. The prevalence of LBP correlates with participation in sports and level of competition. 4,6,7 There is a U-shaped association between physical activity and the incidence of LBP in school-aged children, with both low and high levels of physical activity associated with a higher risk. 8,9 Female sex, growth acceleration, adverse psychosocial factors, increasing age, previous back injury, and family history of LBP are all potential risk factors for school-aged children to develop LBP. 9-12 Although there has been concern about a potential association of LBP and backpacks, the evidence pointing to use of backpacks as a risk factor is weak. 9 No single risk factor for a first episode of LBP in school-aged children has been definitively validated (level of evidence, 1). 13 Historically, it has been taught that most LBP in school-aged children has an identifiable diagnosis. More recent research has challenged this thinking. A high-quality prospective study of 73 pediatric patients with LBP (level of evidence, 2) followed up for 2 years found that nearly 80% had no definitive diagnosis. 14 Most cases of LBP in school-aged children are nonspecific and self-limiting. 15,16 Discussion and Observations Relevant AnatomyPediatricians need a basic but solid understanding of the anatomy of the lumbosacral spine to provide effective care to school-aged children with LBP. The lumbar spine is composed of 5 vertebrae IMPORTANCE Low back pain (LBP) in children and adolescents is a common problem. The differential diagnosis of LBP in this population is broad and different from that seen in the adult population. Most causes of LBP are musculoskeletal and benign in their clinical course. Clinicians should have an understanding of the relevant anatomy and the most commonly encountered etiologic factors of LBP in children and adolescents to provide effective care.OBSERVATIONS Low back pain is rarely seen in youth before they reach school age. Subsequently, rates of LBP rise until age 18 years, at which age the prevalence of LBP is similar to that in adults. The differential diagnosis of LBP in this population is broad, and individual etiologic factors are most often associated wit...

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Diagnosis and Treatment of Low Back Pain in the Pediatric Population

Cited by 26 publications

References 81 publications

Common incidental findings on sacroiliac joint MRI in children clinically suspected of juvenile spondyloarthritis

Common incidental findings on sacroiliac joint MRI in children clinically suspected of juvenile spondyloarthritis

Çocuklarda bel ağrısı

Musculoskeletal Low Back Pain in School-aged Children

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