Differential Diagnosis for Back Pain in Patients Less Than 18 Years Old
Single Most Likely Diagnosis
- Musculoskeletal strain: This is the most common cause of back pain in adolescents, often due to overuse or trauma from sports or other physical activities. The justification for this diagnosis is the high prevalence of musculoskeletal injuries in this age group.
Other Likely Diagnoses
- Scoliosis: A common condition in adolescents, characterized by an abnormal lateral curvature of the spine, which can cause back pain.
- Spondylolysis: A defect in the pars interarticularis, the thin piece of bone that connects the superior and inferior articular facets of the spine, often due to repetitive stress or trauma.
- Spondylolisthesis: A condition where one of the vertebrae slips forward over the bone below it, which can cause back pain and stiffness.
- Discitis: Inflammation of the intervertebral disc, often due to infection or trauma.
- Osteoid osteoma: A benign bone tumor that can cause back pain, typically at night or with activity.
Do Not Miss Diagnoses
- Spinal cord tumor: Although rare, spinal cord tumors can cause back pain, weakness, or numbness in the legs, and require prompt diagnosis and treatment to prevent long-term damage.
- Infectious discitis or osteomyelitis: Infections of the spine that can cause back pain, fever, and other systemic symptoms, and require prompt antibiotic treatment to prevent serious complications.
- Spinal fracture: A fracture of the spine, which can be caused by trauma or osteoporosis, and requires prompt diagnosis and treatment to prevent long-term damage.
- Cauda equina syndrome: A rare but serious condition where the nerves in the lower spine are compressed, causing back pain, numbness, and weakness in the legs, and requiring prompt surgical intervention to prevent long-term damage.
Rare Diagnoses
- Ehlers-Danlos syndrome: A genetic disorder that affects the connective tissue, which can cause back pain, joint hypermobility, and other systemic symptoms.
- Scheuermann's disease: A rare condition characterized by kyphosis (forward rounding) of the upper back, which can cause back pain and stiffness.
- Ankylosing spondylitis: A chronic inflammatory disease that affects the spine and other joints, causing back pain, stiffness, and limited mobility.
- Osteogenesis imperfecta: A genetic disorder that affects the bones, causing back pain, fractures, and other systemic symptoms.