Fifteen-minute consultation: a structured approach to the management of a child or adolescent with back pain.
Back pain in childhood is relatively unusual, although as a child matures through adolescence it becomes much more common. At any age, potentially serious illnesses need to be excluded. There are some useful red flags to be aware of when taking a history and performing an examination. We outline a systematic approach when faced with this clinical presentation in a general paediatric setting, with suggestions for initial investigations and when to consider referral to a specialist.


OBJECTIVE
To provide a structured approach for the paediatrician to appropriately manage a child or adolescent who presents with back pain.


METHODS
Review of the literature and description of the approach commonly adopted in a paediatric setting. Extended matching case questions are used to help the reader test their understanding.


CONCLUSIONS
A focused history, specifically asking about red flags, and a careful examination are essential to reach an appropriate differential diagnosis and management plan. Onward referral to a specialist may be required.
Department of Paediatric Rheumatology, Royal Hospital for Sick Children, Edinburgh, UK.
Mary
M
Cruikshank
Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK.
Athimalaipet V
AV
Ramanan
D000293:Adolescent; D001416:Back Pain / Q000175:diagnosis*; D002648:Child; D003937:Diagnosis, Differential; D019468:Disease Management; D006801:Humans; D012017:Referral and Consultation; D013997:Time Factors
Bone Disease; General Paediatrics; Orthopaedics; Rheumatology