Back pain in the pediatric population remains an unusual and concerning complaint that may be an indicator of serious underlying pathology.
Our recent issue Emergency Department Management of Dangerous Back Pain in Children reviews rare but dangerous etiologies of pediatric back pain and highlights signs and symptoms that may raise a red flag for potentially dangerous etiologies of back pain among children and teens.
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Here are a few key points:
- The incidence of benign back pain in pediatric patients is increasing.1
- A careful history and physical examination must be performed on every pediatric patient with back pain, as imaging and blood work are not recommended universally but targeted by symptoms and examination findings.
- Referred pain from nonspinal pathologies should always be considered, including painful dermatologic conditions; pulmonary conditions such as pneumonia or pleural effusion; genitourinary conditions such as pyelonephritis or nephrolithiasis; gynecologic conditions such as pregnancy or hematocolpos; and gastrointestinal conditions such as constipation and inflammatory bowel disease. (See Table 1, page 5.)
- Identified red flags for pathologic back pain can be found in Table 2, page 8.