Differential Diagnosis for 13M Patient with Back Pain
- Single most likely diagnosis:
- Musculoskeletal strain: The patient's history of possible strain 1-2 weeks ago, constant lower back pain with any movement, and some relief with Advil and a heating pad suggest a musculoskeletal issue, which is common in adolescents, especially with a recent sports-related activity.
- Other Likely diagnoses:
- Spondylolysis: A common cause of back pain in adolescents, especially those involved in sports, due to a stress fracture in the vertebrae.
- Scoliosis: Although the patient's symptoms do not directly suggest scoliosis, it is a condition that can cause back pain in adolescents and should be considered, especially if there is an abnormal curvature of the spine.
- Discitis or herniated disc: These conditions can cause back pain in adolescents, especially with constant pain and pain with movement.
- Do Not Miss diagnoses:
- Spinal infection (e.g., osteomyelitis, discitis): Infections in the spine can present with back pain and are critical to diagnose early to prevent long-term damage.
- Tumor (e.g., osteosarcoma, Ewing's sarcoma): Although rare, spinal tumors can cause back pain in adolescents and are crucial to diagnose early for effective treatment.
- Spinal fracture: A fracture in the spine can cause severe back pain and is essential to diagnose to prevent further injury.
- Rare diagnoses:
- Scheuermann's disease: A rare condition that causes kyphosis (forward rounding of the back) and can lead to back pain in adolescents.
- Ankylosing spondylitis: A rare inflammatory disease that can cause back pain and stiffness in adolescents, although it is more common in adults.
- Osteogenesis imperfecta: A rare genetic disorder that can cause brittle bones and back pain in adolescents.