A study of low back pain in pediatrics visiting OPD
Journal Title: International Journal of Medical and Health Research - Year 2017, Vol 3, Issue 4
Abstract
Pediatric patients require a systematic approach to treating back pain that minimizes the number of diagnostic studies without missing specific diagnoses. This study reviews an algorithm for the evaluation of pediatric back pain and assesses critical factors in the history and physical examination that are predictive of specific diagnoses. Eighty-seven pediatric patients with thoracic and/or lumbar back pain were treated utilizing this algorithm. If initial plain radiographs were positive, patients were considered to have a specific diagnosis. If negative, patients with constant pain, night pain, radicular pain, and/or an abnormal neurological examination obtained a follow-up magnetic resonance imaging. Patients with negative radiographs and intermittent pain were diagnosed with nonspecific back pain. Twenty-one (24%) of 87 patients had positive radiographs and were treated for their specific diagnoses. Nineteen (29%) of 66 patients with negative radiographs had constant pain, night pain, radicular pain, and/or an abnormal neurological examination. Ten of these 19 patients had a specific diagnosis determined by magnetic resonance imaging. Therefore, 31 (36%) of 87 patients had a specific diagnosis. Back pain of other 56 patients was of a nonspecific nature. No specific diagnoses were missed at latest follow-up. Specificity for determining a specific diagnosis was very high for radicular pain (100%), abnormal neurological examination (100%), and night pain (95%). Radicular pain and an abnormal neurological examination also had high positive predictive value (100%). Lumbar pain was the most sensitive (67%) and had the highest negative predictive value (75%). This algorithm seems to be an effective tool for diagnosing pediatric back pain, and this should help to reduce costs and patient/family anxiety and to avoid unnecessary radiation exposure.
Authors and Affiliations
Dr. Sanjeev Kumar
Keywords
Related Articles
- EP ID EP585376
- DOI -
- Views 144
- Downloads 0
Efficacy of Safoof Khabsul Hadeed in iron deficiency anemia during pregnancy: A randomised controlled trial
Background and Objectives: Anemia is the commonest medical disorder in pregnancy which exists worldwide especially among the developing countries. Iron deficiency anemia during pregnancy continues to be one of the most p...
Incidence of fungal keratitis in patients with corneal ulcer in tertiary care centre of western Rajasthan
Aims & Objective: The purpose of this study was to determine the predominant causative microorganism, and to identify the predisposing factor of fungal keratitis. Materials & Method: The study was conducted in department...
Comparision of the tensile and peel bond strength of the silicone and acrylic soft liner following denture base treatment: An In vitro study
Aim: The study was conducted to compare the peel and tensile bond strength of some of the commercially available soft liners with denture base resin and the effect of surface pre-treatment of denture base resin with meth...
C2/C3 nerve blocks and greater occipital nerve (GON) block in treatment of cervicogenic headache
Purpose: To evaluate C2/C3 nerve blocks and greater occipital nerve (GON) block in treatment of cervicogenic headache in patients referring to pain clinic of Amir Alam hospital. Method: In this retrospective cohort, reco...
Clinical study of HELLP syndrome in tertiary care Hospital
Introduction: Every woman’s wish is to end her pregnancy with a healthy baby and a healthy mother. Unfortunately, some women develop pregnancy induced hypertension sometimes ending in its dreaded complications. PIH is on...