Back pain in children who present to the emergency department

The purpose of this study was to identify the causes and epidemiology of ba ck pain in children who present to the emergency department. All children w ho presented to an urban pediatric emergency department (ED) during a 1-yea r period with the chief complaint of back pain were examined and evaluated with a uniform questionnaire, This was completed at the time of the ED visi t in 48%, and within 48 hours in 52%, During a 1-year period, 225 children with a complaint of back pain were evaluated. The mean age was 11.9 +/-4 ye ars and 60% were female. Onset was acute (less than or equal to 2 days) in 59%, and chronic (greater than or equal to 4 weeks) in only 11.6%, Pain awa kened children from sleep in 47%, and caused 52% to miss school or work, Th e most common diagnoses were direct trauma (25%), muscle strain (24%), sick le cell crises (13%), idiopathic (13%), urinary tract infection (5%), and v iral syndrome (4%), Radiographs of the back were rarely helpful. About 5% r equired hospital admission; one half of these were attributed to sickle cel l crises. We conclude that back pain is an uncommon reason for children to present to an emergency department. When present, pediatric back pain is mo st often musculoskeletal, associated with an acute infectious illness or a traumatic event. Although the etiology is rarely serious, back pain often a ffects the daily activities of symptomatic children.