Screening Children with Low Back Pain

Low back pain in children raises a red flag. There have been reports that back pain in children is rare and usually serious. More recent studies show this isn't true. Children and adolescents often have mechanical back pain similar to adults. But screening is still important.

In this study researchers look at the reliability of Technetium bone scan to diagnose back pain in children up to age 18. A group of 142 children and adolescents were included in this study. They were divided into groups based on age and location of pain (neck, upper back, lower back).

All patients had an X-ray and a bone scan. Some had blood tests and others had an MRI. A known diagnosis was made in about half the cases. Bone scan was positive one-third of the time but more than half the children had pathologic findings. This means that bone scan sensitivity was low.

Signs and symptoms reported by young patients with back pain are unreliable when trying to detect the presence of serious disease. Doctors would like to find one simple test to sort out the cause and avoid unnecessary and costly testing. The authors say the Technetium bone scan has its place as a study tool in diagnosis. It doesn't always show infection or malignant tumors and that's a concern.