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"Back
pain is common in adults, and the majority
of the time, it's nothing serious.
But when children complain, doctors
and parents should be concerned."
Vesna
Martich Kriss, M.D., Associate Professor
of Radiology and Pediatrics at the University
of Kentucky College of Medicine.
LEXINGTON, KY -- (Nov. 29, 1999) --
A child who complains of an aching back
shouldn't be ignored, even if an
initial X-ray exam doesn't reveal
a problem. When children complain of
back pain, about a third of the time
there's a serious reason, whether
due to an injury, infection or a tumor,
according to information presented today
at the 85th Scientific Assembly and
Annual Meeting of the Radiological Society
of North America (RSNA).
"Back pain is common in adults,
and the majority of the time, it's
nothing serious," said Vesna Martich
Kriss, M.D., an associate professor
of radiology and pediatrics at the University
of Kentucky College of Medicine. "But
when children complain, doctors and
parents should be concerned.
"Even if an initial X-ray doesn't
show anything, parents shouldn't
stop there if pain persists," she
said. "For instance, sometimes
a fracture after a trauma doesn't
show up in an X-ray for a week or two.
A second X-ray may be necessary if the
child continues to complain, and occasionally,
a bone scan may be necessary to get
to the root of the problem."
Adolescent athletes ¾
gymnasts in particular ¾
are prone to back injuries because they're
often competing at high levels and putting
stress on immature bones, Kriss said.
Other potential problems include infection
and bone tumors. Osteomyelitis is a
bone infection that can not only interfere
with growth but also can destroy bone.
Although not common among healthy kids
¾
only several thousand children contract
it annually ¾
the infection is serious and must be
treated before it causes permanent damage
to the bone. And while cancer is rare
in adolescents, bone tumors are one
of the most common tumors in that group,
with about 900 new cases every year.
It is twice as common in males as in
females.
In a UK study, of 69 children complaining
of low back pain, 21 were identified
as having back lesions by bone scan,
or a single photon emission computed
tomography (SPECT), while X-ray detected
problems in only 8 children.
In a bone scan, the patient is injected
with a radioactive tracer, which collects
in the areas of the bone with high activity,
caused by tumor, infection or trauma.
The patient lies under a device called
a gamma camera, which detects where
the tracer has accumulated. "Abnormalities
often light up like a light bulb,"
Kriss said.
"Once the skeleton matures when
the child reaches approximately age
18, then they're in the adult realm,
and back pain becomes less of a concern,"
she said.
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