Back Pain in a Pediatric Emergency Department: Etiology and Evaluation

Details

• Personal Author:
  Brooks, Thomas M. ; Friedman LM ; Lerer T ; Milewski MD ; Silvis RM
• Description:
  Objectives: Back pain is an uncommon chief complaint in the pediatric emergency department (ED). However, there are serious underlying conditions requiring prompt diagnosis and treatment. While the etiology is usually benign, variation exists in the evaluation. The study purpose was to describe pediatric patients who presented to the ED with back pain and evaluate for associations with laboratory and radiologic abnormalities indicative of underlying musculoskeletal pathology. Methods: A retrospective review was conducted of patients aged birth to 18 years who presented to a pediatric ED with a chief complaint of back pain during a 1-year period. Primary outcome was discharge diagnosis, categorized as nonpathologic back pain, pathologic back pain, and other etiologies. Descriptive statistics were used. Results: Two-hundred thirty-two patient encounters were reviewed, with 177 included in data analysis. A nonpathologic diagnosis of back pain was found in 76.8% of visits. Back pain and back or muscle strain were the most common diagnoses. Pathologic back pain diagnoses represented 2.3% of visits. Radiologic imaging was performed in 37.9%. Positive findings were noted in 16.9% of radiographs; no abnormalities were noted on computed tomography scan or magnetic resonance imaging. Laboratory studies were conducted in 35%. Abnormal plain radiographs were associated with a pathologic diagnosis of back pain (P < 0.001). Conclusions: Most pediatric patients presenting to the ED with back pain were found to have a nonpathologic etiology and were discharged. Among those with a pathologic back pain diagnosis, abnormal radiograph findings were the only statistically significant factor, whereas laboratory studies, computed tomography scans, and magnetic resonance imaging scans were less indicative. [Description provided by NIOSH]
• Subjects:
  Adolescent Diagnosis Emergency Responders Health Care Facilities Workforce And Services Laboratories Musculoskeletal Diseases Musculoskeletal System Occupational Health Pathology Radiography Safety

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• Keywords:
  Adolescents Author Keywords: Back Pain Back Pain Children Clinical Diagnosis Diagnostic Techniques Emergency Care Emergency Treatment Etiology Health Care Facilities Imaging Techniques Laboratory Testing Low Back Pain Medical Treatment MSD Musculoskeletal System Disorders Radiographic Analysis Radiologic Imaging

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• ISSN:
  0749-5161
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Connecticut ; Illinois ; New York ; OSHA Region 1 ; OSHA Region 2 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  34
• Issue:
  1
• NIOSHTIC Number:
  nn:20051404
• Citation:
  Pediatr Emerg Care 2018 Jan; 34(1):e1-e6
• Contact Point Address:
  Talia M. Brooks, MD, 269-01 76th Avenue, New Hyde Park, NY 11040
• Email:
  tbrooks@northwell.edu
• Federal Fiscal Year:
  2018
• Performing Organization:
  University of Illinois at Chicago
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Pediatric Emergency Care
• End Date:
  20290630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ae5aa121ff38e9933a09e162a856091995e0749e610888d44a542a26191dbb6d41397e39629cf0280340681f5f0d1b58306f778d3be909391cab3e2863d0011c
• Download URL:
  https://stacks.cdc.gov/view/cdc/211375/cdc_211375_DS1.pdf
• File Type:
  [PDF - 170.95 KB ]