Clinical examination and imaging resources in children and adolescent back pain

Abstract

Back pain is a relatively common complaint in children and adolescents. The pediatric patient presenting with back pain can often be challenging, and there are many well-known organic diagnoses that should not be missed. In younger children, an organic cause of back pain can often be found. However, back pain in older children and adolescents is often “non-specific.” The differential diagnosis of back pain in children includes neoplasms, developmental, and inflammatory conditions. Basic steps should include an in-depth anamnesis, a systematic physical examination, and standard spine radiographs (anteroposterior and lateral). Nevertheless, advanced diagnostic imaging and laboratory studies should be included when indicated to avoid missing or delaying a serious diagnosis. If other types of imaging tests are necessary (magnetic resonance imaging, computed tomography, bone scan, or single photon emission computed tomography), they should be guided by diagnostic suspicion.

Clinical presentation and imaging findings in juvenile-onset back pain: a ten-year hospital-based retrospective analysis in Douala (Cameroon)

“…Back pain is one of the most widespread diseases of the musculoskeletal system and a leading global cause of years lived with disability ( 1 , 2 ). Thought to be the prerogative of adults and elderly, back pain, particularly low back pain, is increasingly being described in children and adolescents ( 3 , 4 ). Due to the heterogenicity of studies and the limited use of healthcare facilities, the true prevalence of juvenile-onset back pain (JOBP) in children and adolescents is not well-known ( 3 ).…”

“…Thought to be the prerogative of adults and elderly, back pain, particularly low back pain, is increasingly being described in children and adolescents ( 3 , 4 ). Due to the heterogenicity of studies and the limited use of healthcare facilities, the true prevalence of juvenile-onset back pain (JOBP) in children and adolescents is not well-known ( 3 ). Its incidence and prevalence in Western countries are thought to be increasing in this age group.…”

“…Its incidence and prevalence in Western countries are thought to be increasing in this age group. JOBP is much more frequent in the teenage years, with a high risk of conditions becoming chronic and might predict future back pain in adulthood ( 3 – 6 ).…”

“…In contrast to the long-held perception that JOBP is generally transient and insignificant in terms of impact on individuals, evidence suggests that it significantly impairs a substantial minority of children and adolescents who complain about it. This leads to absenteeism from school or work and/or missing out on sports or physical activities ( 3 , 4 , 6 ).…”

“…The available evidence recommends that every child with a complaint of back pain needs an extensive evaluation using advanced imaging and blood work to establish an underlying cause ( 3 – 5 , 8 , 10 – 13 ). The differential diagnosis of back pain in childhood is broad and different from that seen in adults.…”