Without using an X-ray, what would make the doctor suspect my child has spondylolysis? And what will happen if the doctor doesn't see it on the X-ray?

Spondylolysis is an injury that affects teen-agers who participate in repetitive sports or activities. If your child does compete in activities like gymnastics or football, for example, and is complaining about pain in the lower back that worsens with activity, but is better after resting, the doctor may be thinking about spondylolysis. Your child's doctor will take a history, and ask questions like what types of activities your child enjoys, when the back hurts, and when it feels better. After that, the doctor will probably check your child's posture, movement, and muscle strength. Based on this, the doctor may send your child for an X-ray.

Since spondylolysis is a fatigue or stress fracture, there are times that it might not seen on an X-ray. If your child's doctor wants to follow up further before beginning treatment, he or she may order a bone scan or an imaging test. These tests can give a more accurate view of the vertebrae in the spine.