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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
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Warning signs of potentially serious causes of back pain in children and adolescents

Warning signs of potentially serious causes of back pain in children and adolescents
Clinical feature Potential significance
Abnormal neurologic findings:
  • Asymmetric reflexes
  • Weakness
  • Extensor plantar response
  • Low rectal tone*
  • Bowel or bladder dysfunction
  • Spinal epidural abscess
  • Transverse myelitis
  • Spinal cord tumor
  • Nerve root compression
History of acute or repetitive trauma (particularly lumbar hyperextension)
  • Spondylolysis
  • Spondylolisthesis
Pain that radiates below the buttocks
  • Intervertebral disc herniation
  • Apophyseal ring fracture
Pain that is severe (eg, interferes with activity), constant (unrelated to activity), occurs at night, or is progressive
  • Inflammatory arthritis
  • Spinal tumor (benign or malignant)
  • Spinal cord tumor
  • Spinal infection (eg, vertebral osteomyelitis, osteomyelitis, discitis, epidural abscess)
  • CNO/CRMO involving the vertebrae or pelvis
  • Tethered cord, syringomyelia (in children with severe pain and scoliosis)
  • Nephrolithiasis
  • Vaso-occlusive pain in children with sickle cell disease
Fever
  • Spinal or paraspinal infection (eg, osteomyelitis, epidural abscess)
  • Extraspinal infection (eg, pneumonia, pyelonephritis, viral infection with myalgia)
  • Pancreatitis
  • Cholecystitis
Fever and weight loss or other systemic findings
  • Malignant tumors (eg, leukemia, lymphoma, Langerhans cell histiocytosis, Ewing sarcoma)
  • Inflammatory bowel disease-associated arthritis
Morning stiffness that lasts longer than 30 minutes
  • Inflammatory arthritis
History of malignancy
  • Spinal metastases
History of exposure to tuberculosis
  • Tuberculous spondylitis (Pott disease)
<10 years
  • Increased concern for:
    • Malignancy (eg, leukemia, Langerhans cell histiocytosis)
    • Infection (eg, osteomyelitis, discitis)

CNO/CRMO: chronic nonbacterial osteomyelitis/chronic recurrent multifocal osteomyelitis.

* If rectal examination is indicated.
Graphic 77644 Version 9.0

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