Are Constant Pain, Night Pain, or Abnormal Neurological Examination Adequate Predictors of the Presence of a Significant Pathology Associated With Pediatric Back Pain?

Journal of Pediatric Orthopedics
Norman RamirezIván Iriarte

Abstract

Previous studies have suggested that most cases of pediatric back pain do not have an identifiable cause. No reliable sign or indication differentiates between a benign or serious cause of the symptom. Constant pain, night pain, and abnormal neurological examination have been suggested as adequate predictors of an identifiable cause, when plain radiographs could not explain the symptoms. The purpose of this study is to determine the sensitivity, specificity, and likelihood ratios of constant pain, night pain, and abnormal neurological examination to predict the presence of an underlying positive finding as a cause of back pain. From 2010 to 2016, all patients who presented with a chief complaint of back pain were included in the study. Magnetic Resonance Image was performed to all patients presenting with back pain without identifiable cause lasting >4 weeks. Patients who presented with spondylolysis were treated accordingly base on radiographic findings and were excluded as study protocol. A total of 388 patients were evaluated during the study period. The mean age of the subjects was 14.5 years; 69.7% being female. An underlying pathologic condition was identified in 56 of 132 (42%) of patients with constant pain, 61 of 162 (...Continue Reading

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Citations

Mar 31, 2021·Rheumatic Diseases Clinics of North America·David G Borenstein, Federico Balagué
Aug 20, 2021·Journal of Pediatric Orthopedics·Mitchell A JohnsonKeith D Baldwin

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Methods Mentioned

BETA
imaging techniques

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