The main etiologies for adolescent back pain can be put into several general categories that are listed in Table 1.
Table 1 Etiologies of Adolescent Back Pain
Nonspecific back pain Mechanical Lumbar strain
Apophyseal ring fracture, sacral fracture Transitional vertebrae Spinal cord anomalies Nonaccidental trauma Idiopathic pain syndromes
Enthesitis related arthritis Psoriatic arthritis
Systemic lupus erythematosus, mixed connective tissue disease, dermatomyositis Vascular
Hemoglobinopathies (i.e., sickle cell disease, thalassemia) Arteriovenous malformation Spinal infarct Infectious Osteomyelitis Discitis
Epidural abscess Tumor
Benign bone tumors and tumor-like lesions Malignant bone tumors: primary and metastatic Spinal cord tumors Psychological
Psychogenic/conversion reaction Referred pain Hip
Abdominal (i.e., pyelonephritis, urinary tract infection, pancreatitis, appendicitis)
Pelvic (i.e., ovarian cyst, perineural cyst, hematocolpos/imperforate hymen) Thoracic (i.e., pneumonia, pleuritis)
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