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Pediatric back pain

Josef N Tofte, Tyler L CarlLee, Andrew J Holte, Sean E Sitton, Stuart L Weinstein
STUDY DESIGN: Systematic Review. OBJECTIVE: To provide an evidence-based recommendation for when and how to employ imaging studies when diagnosing back pain thought to be caused by spondylolysis in pediatric patients. SUMMARY OF BACKGROUND DATA: Spondylolysis is a common structural cause of back pain in pediatric patients. The radiologic methods and algorithms used to diagnose spondylolysis are inconsistent among practitioners. METHODS: A literature review was performed in PubMed and Cochrane databases using the search terms "spondylolysis" "pediatric" "adolescent" "juvenile" "young" "lumbar" "MRI" "bone scan" "CT" and "SPECT"...
September 23, 2016: Spine
David Dornbos, Jocelyn Morin, Joshua R Watson, Jonathan Pindrik
Osteomyelitis of the spine with associated spinal epidural abscess represents an uncommon entity in the pediatric population, requiring prompt evaluation and diagnosis to prevent neurological compromise. Cat scratch disease, caused by the pathogen Bartonella henselae, encompasses a wide spectrum of clinical presentations; however, an association with osteomyelitis and epidural abscess has been reported in only 4 other instances in the literature. The authors report a rare case of multifocal thoracic osteomyelitis with an epidural abscess in a patient with a biopsy-proven pathogen of cat scratch disease...
September 23, 2016: Journal of Neurosurgery. Pediatrics
Ozgul Yigit, Meltem Erol, Ozlem Bostan Gayret, Isıl Ustun, Selami Ulas
INTRODUCTION: Tuberculosis remains a major public health problem in developing countries. Diagnosing extrapulmonary tuberculosis can be difficult, as it requires a higher index of suspicion than primary tuberculosis. Extrapulmonary tuberculosis may mimic malignancies and many other diseases, so it should be included in the differential diagnosis. Here, we present a case of extrapulmonary tuberculosis associated with Pott's disease and hip arthritis in a patient who recovered after 12 months of antituberculosis therapy...
July 2016: Iranian Red Crescent Medical Journal
Bobby Wirawan Hassan, Bong Ju Moon, Young-Jin Kim, Sang-Deok Kim, Ki-Young Choi, Jung-Kil Lee
INTRODUCTION: Langerhans cell histiocytosis (LCH) occurs rarely in the spine of adults. The radiological findings usually resemble vertebral tumors. Etiology of LCH has not been clearly established yet. Therapeutic approaches are still controversial. We describe a case of LCH in an adult spine. CASE DESCRIPTION: A patient who presented with low back pain had an osteolytic lesion in the L1 vertebral body without neurological deficits, and fluoroscopy-guided needle biopsy of the L1 vertebral body was performed...
2016: SpringerPlus
Barbara K Bruce, Chelsea M Ale, Tracy E Harrison, Susan Bee, Connie Luedtke, Jennifer Geske, Karen E Weiss
OBJECTIVE: This study examined key functional outcomes following a 3-week interdisciplinary pediatric pain rehabilitation program for adolescents with chronic pain. Maintenance of gains was evaluated at three-month follow-up. METHODS: Participants included 171 adolescents (12-18 y of age) with chronic pain who completed a hospital-based outpatient pediatric pain rehabilitation program. Participants completed measures of functional disability, depressive symptoms, pain catastrophizing, opioid use, school attendance, and pain severity at admission, discharge, and at 3-month follow-up...
August 31, 2016: Clinical Journal of Pain
Mohammad M Alzahrani, Saad M Alqahtani, Michael Tanzer, Reggie C Hamdy
INTRODUCTION: Forceful and repetitive maneuvers constitute the majority of pediatric orthopedic surgical tasks, thus subjecting surgeons to the risk of musculoskeletal (MSK) injuries during their years in practice. The aim of this study was to assess the prevalence, characteristics and impact of MSK disorders among pediatric orthopedic surgeons. METHODS: A modified version of the physical discomfort survey was sent to surgeons who were members of the Pediatric Orthopedic Society of North America (POSNA) via e-mail...
October 2016: Journal of Children's Orthopaedics
Aasheen Munshey, Justin Moore, Catriona Maclean, Anthony Longano, Tony Goldschlager
BACKGROUND: Pilocytic astrocytoma (PA) is a benign neoplasm that typically occurs in the brain within the pediatric and adolescent age groups and is uncommon in adults. It rarely occurs within the ventricles and the overall prognosis is favourable. A pilocytic astrocytoma of the brain with spinal metastasis at presentation has never been reported in an adult. CASE DESCRIPTION: We report a case of a 47-year-old male presenting with sudden onset frontal headache associated with nausea and lethargy...
August 12, 2016: World Neurosurgery
Young-Ju Yun, Yong-Beom Shin, Soo-Yeon Kim, Myung-Jun Shin, Ra-Jin Kim, Tae-Young Oh
[Purpose] The purpose of this study was to develop the Korean version of the PedsQL(TM) 3.0 Cerebral Palsy Module to evaluate the health-related quality of life of children with cerebral palsy and to test the reliability and validity. [Subjects and Methods] The study included 108 caregivers of children with cerebral palsy aged 2 to 4 years and 72 caregivers of children aged 5 to 7 years, who visited multiple sites between February and August 2015. The Translation Commission performed the first translation with the approval of the Mapi Research Trust Company to create a Korean-version of the PedsQL(TM)...
July 2016: Journal of Physical Therapy Science
Ryan Eid, Ashok Raj, Darren Farber, Vinay Puri, Salvatore Bertolone
Spinal cord infarction (SCI) is extremely rare in children, and only 2 other reports have described the occurrence of SCI in patients with hemoglobin SC disease (HbSC). Amusement park accidents are serious injuries. Patients with preexisting conditions, such as hypertension, cardiac disease, and recent back or neck injuries, may be at an increased risk. We report the case of a 12-year-old girl with HbSC with a past history of only 2 admissions for pain crises, who presented to the emergency department with symptoms of SCI after riding a roller coaster...
September 2016: Pediatrics
Christiane G Kruppa, Justin D Khoriaty, Debra L Sietsema, Marcel Dudda, Thomas A Schildhauer, Clifford B Jones
INTRODUCTION: With an incidence of less than 0.2% of all pediatric fractures, pelvic ring injuries are rare. Historically they were conservatively treated, but because malunion and long-term morbidity are associated with unstable injuries, a trend towards operative treatment can be observed. The purpose was to determine clinical and radiographic outcomes following these complex pediatric pelvic ring injuries. PATIENTS AND METHODS: This Level IV retrospective analysis was completed at a private orthopaedic practice in association with a Level One teaching trauma center...
October 2016: Injury
Ailing Guo, Fuyou Guo
INTRODUCTION: Spinal synovial sarcoma (SS) is an extremely rare malignant tumor in children. CASE REPORT: We report an unusual pediatric synovial sarcoma located in the thoracic spine at T9-T10 levels. A 10-year-old boy was admitted with a 1-month history of progressive back pain and low fever for 7 days as well as sudden onset of paraplegia for 1 day. The primary diagnosis was considered for spinal inflammatory abscess; subsequently, the patient underwent total resection with a good recovery and confirmed SS by SYT-SSX gene translocation...
July 21, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Michela Massoud, Francesca Del Bufalo, Anna Maria Caterina Musolino, Paolo Maria Schingo, Stefania Gaspari, Mara Pisani, Cinzia Orazi, Antonino Reale, Umberto Raucci
BACKGROUND: Low back pain is a common symptom in the pediatric population; approximately half of all children present with at least one episode of low back pain. The majority of cases are due to nonspecific causes such as musculoskeletal trauma with spontaneous regression. On some occasions, however, life-threatening diseases have to be considered. CASE REPORT: A 15-year-old girl presented to the Pediatric Emergency Department for a history of continuous 2-day duration of low back pain and transient paresthesia of the right gluteal area...
September 2016: Journal of Emergency Medicine
N Roessler, C Allen Debeaurepaire, A Deprez, L Tanche, V Pavageau, A Hamain, C Grave, A Yatzimirsky, L Vallée, J Avez-Couturier
INTRODUCTION: Chronic pain in children and adolescents has a major impact on their life in terms of school, sleep as well as family and social life. Teenagers aged 13-15 and girls are at the highest risk. Zeltzer et al. established a bio-psychosocial model of chronic pain in 1998 to account for all its dimensions and advocated a multidisciplinary management plan. Programs based on their principles target specific symptoms such as anxiety and loss of function, while treating underlying factors and teaching coping skills to patients and their families...
August 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Jason B Samarasena, Nathaniel H Kwak, Kenneth J Chang, John G Lee
BACKGROUND AND AIMS: When PEG tube feeding is complicated by anatomic obstruction, dysmotility, or aspiration, a need arises for feeding beyond the pylorus. The currently available percutaneous gastrojejunostomy (PEG-J) kits have issues with the jejunal extension portion migrating back into the stomach. The aim of this study was to evaluate the feasibility and safety of a novel technique that creates PEG-J tubes by combining an adult percutaneous gastrostomy (PEG) tube with a pediatric PEG tube, the PEG-Pedi-PEG procedure...
June 18, 2016: Gastrointestinal Endoscopy
Mattia Bellan, Rossella Molinari, Luigi Castello, Daniele Sola, Antonello Gibbin, Giulia Guaschino, Roberta Pedrazzoli, Alessia Puma, Mario Pirisi, Gian Carlo Avanzi, Pier Paolo Sainaghi
Non-traumatic musculoskeletal complaints are often dealt with by emergency room (ER) physicians. We aimed to quantify how many patients with such complaints have conditions requiring immediate recognition and treatment, versus specialist referral, versus primary care. We retrieved the clinical records of all the patients admitted to the ER department of our hospital along 1 year. Pediatric (age <14 years) and obstetrics/gynecology cases were excluded. Data from all patients visiting the ER for non-traumatic musculoskeletal complaints were classified as follows: true emergencies (i...
June 17, 2016: Clinical Rheumatology
Tapas Kumar Sabui, Moumita Samanta, Rakesh Kumar Mondal, Indira Banerjee, Abishek Saren, Avijit Hazra
OBJECTIVE: To study the prevalence and pattern of musculosketetal abnormalities in school-going children living in the hilly and foothill regions of the Eastern Himalayas using the pediatric Gait, Arms, Legs, Spine (pGALS) screening tool. METHODS: Total of 3608 children, aged 3-12 years were enrolled from 16 schools (5 in the hills) in the eastern Himalayan region. After the three screening questions, the pGALS maneuvers were administered. Subjects were shown a video on pGALS before the actual testing...
June 16, 2016: International Journal of Rheumatic Diseases
Chieh-Tsai Wu, Pei-Kwei Tsay, Tang-Her Jaing, Shih-Hsiang Chen, Chen-Kan Tseng, Shih-Ming Jung
Oligodendrogliomas occurring rarely in children are incompletely characterized. The purpose of this study was to identify prognostic factors affecting the local control and survival in the management of children with oligodendrogliomas. We retrospectively analyzed clinical data on 20 pediatric patients with oligodendrogliomas treated at Chang Gung Children's Hospital between 1994 and 2014. There were 12 males and 8 females with a median age of 9.2 years at diagnosis (range, 3 mo to 18 y). Eighteen (90%) tumors were located in the cerebral hemispheres, 10 cases were located on the right, 8 on the left...
October 2016: Journal of Pediatric Hematology/oncology
Kunal R Bansal, Ajay S Chandanwale
INTRODUCTION: Spinal cord injury in children frequently occurs without fracture or dislocation. SCIWORA is a syndrome occurring when the spinal cord sustains neural damage during a traumatic event without positive radiographic findings. The incidence of SCIWORA was found to be 8% to 32% in various studies with very few cases documented in children below the age of 1 year. We report such a case of spinal cord injury without radiological abnormality in an 8 months old female child. CASE REPORT: An 8 months old female child was brought to the emergency room after a history of fall from the bed four days back...
January 2016: Journal of Orthopaedic Case Reports
Gregory D Schroeder, Cynthia R LaBella, Marco Mendoza, Erika L Daley, Jason W Savage, Alpesh A Patel, Wellington K Hsu
PURPOSE: To determine if adolescent athletics increases the risk of structural abnormalities in the lumbar spine. METHODS: A retrospective review of patients (ages 10-18) between 2004 and 2012 was performed. Pediatric patients with symptomatic low back pain, a lumbar spine MRI, and reported weekly athletic activity were included. Patients were stratified to an "athlete" and "non-athlete" group. Lumbar magnetic resonance and plain radiographic imaging was randomized, blinded, and evaluated by two authors for a Pfirrmann grade, herniated disc, and/or pars fracture...
September 2016: European Spine Journal
Joshua Adam Delavan, Nicholas V Stence, David M Mirsky, Jane Gralla, Michael F Fadell
BACKGROUND: Limited z-axis-coverage computed tomography (CT) to evaluate for pediatric lumbar spondylolysis, altering the technique such that the dose to the patient is comparable or lower than radiographs, is currently used at our institution. The objective of the study was to determine whether volumetric 3-dimensional fast spin echo magnetic resonance imaging (3D MRI) can provide equal or greater diagnostic accuracy compared with limited CT in the diagnosis of pediatric lumbar spondylolysis without ionizing radiation...
July 2016: Sports Health
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