Back Pain in Children and Adolescents: Evaluation and Differential Diagnosis

Back pain in children and adolescents usually has a recognizable organic origin. The most common entities seen are spondylolysis, spondylolisthesis, Scheuermann's kyphosis, disk herniations, infections, and tumors. Early recognition and treatment can provide patients the best chance at relief of symptoms and eradication of the underlying disease process. The goals of this review are to (1) familiarize the clinician with the various diagnoses associated with back pain in the skeletally immature patient and (2) to assist the clinician in making the appropriate diagnosis by providing a rational method of selecting diagnostic tests that maximize specificity and minimize costs.