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Evaluation and Diagnosis of Back Pain in Children and Adolescents

Shah, Suken A. MD; Saller, Jeremy MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: January 2016 - Volume 24 - Issue 1 - p 37–45
doi: 10.5435/JAAOS-D-14-00130
Review Article

Although traditionally it has been accepted that back pain in young children and adolescents most often has an organic etiology, nonorganic back pain in this population is becoming more common. The most common identifiable clinical entities responsible for such pain are spondylolysis, spondylolisthesis, Scheuermann kyphosis, overuse syndromes, disk herniation, apophyseal ring fracture, spondylodiscitis, vertebral osteomyelitis, and neoplasm. Appropriate clinical workup leads to earlier diagnosis and management of back pain and avoids unnecessary cost. Knowledge of the most common diagnoses associated with back pain in children and adolescents and the use of a systematic method to select the appropriate diagnostic tests can help the clinician to minimize costs and maximize the likelihood of making the correct diagnosis and providing appropriate treatment.

From the Department of Orthopaedic Surgery, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.

Dr. Shah or an immediate family member has received royalties from Arthrex and DePuy Synthes Spine; serves as a paid consultant to DePuy Synthes Spine; serves as an unpaid consultant to OrthoPediatrics; has stock or stock options held in Globus Medical; has received research or institutional support from DePuy Synthes Spine; and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons, the Scoliosis Research Society, the Pediatric Orthopaedic Society of North America, and the Setting Scoliosis Straight Foundation. Neither Dr. Saller nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

Received June 18, 2014

Accepted February 18, 2015

© 2016 by American Academy of Orthopaedic Surgeons
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