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Chapter 44: Back Pain in a Child

Munesha Ramsinghani Lona; Josiane Stickles

Description of the Symptom

This chapter describes possible causes of back pain in a child, including the region of the posterior body between the eighth rib and posterior superior iliac spines.

Special Concerns

  • Changes in functional mobility

  • Fever

  • Night pain, pain at rest, or unremitting pain

  • Unexplained weight loss

  • New or evolving neurological symptoms:

    • Abnormal reflexes/posturing

    • Loss of bowel and/or bladder function

    • Sensory changes

    • Radiating pain

  • Abdominal tenderness

  • Skin rash, tenderness on palpation

  • Postural changes

CHAPTER PREVIEW: Conditions That May Lead to Back Pain in a Child
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CHAPTER PREVIEW: Conditions That May Lead to Back Pain in a Child
T  Trauma
REMOTE LOCAL
COMMON
Not applicable

Muscle strain/overuse syndrome 885

Scheuermann's disease (idiopathic/structural kyphosis) 888

Spondylolisthesis 890

Spondylolysis 890
UNCOMMON
Not applicable

Fractures:

  • Burst 881

  • Compression 881

  • Flexion-distraction 882

  • Fracture-dislocations 882

Lumbar radiculopathy 884
RARE
Not applicable Slipped vertebral apophysis 889
I  Inflammation
REMOTE LOCAL
COMMON
Not applicable

Aseptic

Juvenile rheumatoid arthritis 883

Septic

Not applicable
UNCOMMON
Not applicable

Aseptic

Rheumatoid arthritis-like conditions of the spine:

• Juvenile ankylosing spondylitis 886

Septic

Discitis 880

Tuberculous spondylitis (spinal tuberculosis) 891
RARE

Aseptic

Not applicable

Septic

Acute pelvic inflammatory disease 878

Appendicitis 879

Cholecystitis 879

Pancreatitis 879

Pleuritis (pleurisy) 879

Pyelonephritis 880

Aseptic

Rheumatoid arthritis-like conditions of the spine:

  • Arthritis with inflammatory bowel disease 886

  • Juvenile dermatomyositis 887

  • Psoriatic arthritis 887

  • Systemic lupus erythematosus 888

  • Transverse myelitis 891

Septic

Meningitis 884

Spinal epidural abscess 889

Vertebral osteomyelitis 895
M  Metabolic
REMOTE LOCAL
COMMON
Not applicable Not applicable
UNCOMMON
Not applicable Not applicable
RARE
Not applicable

Idiopathic juvenile osteoporosis 883

Metabolic bone disease 885

Osteogenesis imperfecta (brittle bone disease) 885
Va  Vascular
REMOTE LOCAL
COMMON
Not applicable Not applicable
UNCOMMON
Not applicable Not applicable
RARE
Not applicable

Hemophilia 882

Sickle cell anemia (crisis) 889
De  Degenerative
REMOTE LOCAL
COMMON
Not applicable Not applicable
UNCOMMON
Not applicable Not applicable
RARE
Not applicable Not applicable
Tu  Tumor
REMOTE LOCAL
COMMON
Not applicable Not applicable
UNCOMMON
Not applicable

Malignant Primary, such as:

  • Ewing's sarcoma 892

  • Leukemia 893

  • Lymphoma 893

  • Osteosarcoma (osteogenic sarcoma) 895

Malignant Metastatic:

Not applicable

Benign:

Not applicable
RARE

Malignant Primary, such as:

• Nephroblastoma (Wilms' tumor) 880

Malignant Metastatic:

Not applicable

Benign:

Not applicable

Malignant Primary:

Not applicable

Malignant Metastatic, such as:

  • Astrocytoma 892

  • Neuroblastoma 894

  • Rhabdomyosarcoma 895

Benign, such as:

  • Aneurysmal bone cyst 891

  • Langerhans' cell histiocytosis 892

  • Osteoblastoma 894

  • Osteoid osteoma 894
Co  Congenital
REMOTE LOCAL
COMMON
Not applicable Not applicable
UNCOMMON
Not applicable Not applicable
RARE
Not applicable Joint hypermobility syndrome 883
Ne  Neurogenic/Psychogenic
REMOTE LOCAL
COMMON
Not applicable Not applicable
UNCOMMON
Not applicable Psychosomatic back pain 886
RARE
Not applicable Not applicable

Note:These are estimates of relative incidence because few data are available for the less common conditions.

Common Ages at Which Back Pain Presents in a Child
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Common Ages ...

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