Emergency Department Management of Dangerous Back Pain in Children

Points & Pearls Excerpt

• 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.)