Imaging of low back pain in children and adolescents
Section snippets
Mechanical and developmental causes
The entities included in this group are related to injuries, which may be associated with repetitive low grade trauma or a single major injury.
Infectious and inflammatory causes
Except for neuroarthropathy, where there is absence of sensation, diskitis and all other inflammatory and degenerative arthritides affecting the spine and/or sacroiliac joints may be associated with LBP.
Cysts and tumoral causes
Tumors are an infrequent cause of back pain in children.22 They can be either primary or secondary, in the spine, leptomeninges, or spinal cord. Imaging modalities for the evaluation of spinal tumors include plain radiographs, scintigraphy, CT, MRI, and in rare cases myelography.
Although CT and to a lesser extent plain radiographs help in demonstrating the presence and extent of bony involvement, MRI is often used in conjunction with CT for better delineation of the soft tissue component and
Conclusion
LBP in children and adolescents cannot be ignored. It is a serious condition that must be thoroughly investigated for a specific cause to be identified. This requires an accurate history, including family history, clinical and laboratory examinations, as well as tailored imaging. We have reviewed and illustrated many of the mechanical, developmental, infectious/inflammatory, and neoplastic causes of LBP in the pediatric age group and emphasized the role of MRI as a superb diagnostic tool.
Acknowledgment
We would like to thank Ms. Manon Roy and Ms. Nora Del Pozo for their help in preparation of this manuscript.
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