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E1315. Imaging Low Back Pain in Children
Authors
  1. Dilan Nakatomi; University of Southern California
  2. Patricia Acharya; Children's Hospital Los Angeles (CHLA); University of Southern California
  3. Lillian Lai; Children's Hospital Los Angeles (CHLA); University of Southern California
  4. Jay Acharya; University of Southern California
  5. Skorn Ponrartana; Children's Hospital Los Angeles (CHLA); University of Southern California
Background
Since low back pain (LBP) occurs more frequently in adults, less attention is reserved for the same symptomatology in children and adolescents. However, it is important to realize that LBP is relatively common in the pediatric population. Additionally, for the pediatric patient, the differential diagnosis is not only broad, but notably divergent from adult etiologies of LBP, creating a significant clinical dilemma.

Educational Goals / Teaching Points
The goal of this educational exhibit is to improve the radiologist’s familiarity with imaging findings for the most common causes of pediatric LBP with additional emphasis on the rare, yet potentially life-threatening etiologies. This article discusses the epidemiology of LBP in children; the imaging work-up utilized; and the associated imaging findings for each described cause of LBP in the pediatric patient.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The radiographic, scintigraphic, CT, and MRI appearance of the following causes of pediatric low back pain will be reviewed: spondylolysis, disc degeneration, disc herniation, Bertolotti’s syndrome, apophyseal end plate fractures, Scheuermann’s disease, infectious spondylodiscitis (including vertebral osteomyelitis and discitis), osteoid osteoma/osteoblastoma, Langerhans cell histiocytosis, osteosarcoma, and Ewing’s sarcoma.

Conclusion
The causes of low back pain are unique in children as compared to adults. It is important for the general radiologist to be aware of these differences so that the correct diagnosis can be made in a timely manner and avoid serious adverse outcomes.