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- Craig DeWolfe, MD
- Washington, DC
The presenting concern for back pain in a child is uncommon but often serious. The pain in an adolescent bridges the gap between an identifiable disease and a nonspecific musculoskeletal pain found in many adults. Above all, the complaint from any pediatric patient warrants careful attention because a systematic approach frequently yields a tangible diagnosis.
The differential diagnosis of spondylodynia, or back pain, includes referred pain from an extraspinal organ system such as retrocecal appendicitis, pyelonephritis, or psoas abscess. Traumatic or overuse injuries such as musculoskeletal strain, spondylolysis, spondylolisthesis, or a herniated disc also should be considered. Infection and inflammation of the vertebral column can cause pain, and causes range from discitis and osteomyelitis to juvenile …
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