RadioGraphics, Vol 11, 269-291, Copyright © 1991 by Radiological Society of North America
Common causes of low back pain in children
E Afshani and JP Kuhn
Department of Radiology, Children's Hospital, Buffalo, NY 14222.
Low back pain in children and adolescents is often caused by a serious
problem. The diagnostic investigation should begin with a complete patient
history, complete physical examination, laboratory testing, and plain
radiography. These results should be used to direct further imaging
studies. Although most of the painful injuries that children sustain in
recreational activities are mild, back pain that lasts for extended periods
may be due to various disorders, including spondylolysis and
spondylolisthesis, disk herniation, Scheuermann disease, or neoplasms. Low
back pain can also be caused by diskitis and osteomyelitis, most commonly
found in children younger than 10 years old. Primary osseous neoplasms of
the lumbar spine are uncommon, with Ewing sarcoma, aneurysmal bone cyst,
benign osteoblastoma, and osteoid osteoma being the most common followed by
primary lymphoma. These lesions occur more often between the ages of 5 and
20 years. Other causes of low back pain include spinal cord tumors (eg,
ependymoma), congenital disorders of the spine (eg, scoliosis), and
systemic disease (eg, sickle cell disease).
