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Virtual Pediatric Hospital: Back Pain in Children: Differential Diagnosis for Back Pain in Children Back Pain in Children

Differential Diagnosis for Back Pain in Children

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


A targeted differential diagnosis can be generated by dividing children into two age groups - prepubertal and pubertal. In prepubertal children, the differential includes infection, in the form of diskitis or osteomyelitis, or tumor of the spinal column or spinal cord. In pubertal children, the differential includes tumor of the spinal column or spinal cord, spondylolysis or spondylolisthesis, herniated disk, lumbar strain from overuse, or Scheuermann Disease.

A broad differential diagnosis can be generated using the following mnemonic:

VITAMIN C
V - vascular
I - infection, inflammation
T - trauma
A - autoimmune
M - metabolic
I - idiopathic
N - neoplasm
C - congenital

Vascular
      None
Infection, Inflammation
      Diskitis
      Tuberculosis
      Pyelonephritis
      Ankylosing Spondylitis
      Enteropathic Arthritis
Trauma
      Spondylolysis, spondylolisthesis
      Musculoligamentous
      Herniated disk
Autoimmune
Metabolic
Idiopathic
      Scheuermann Disease
Neoplasm
      Osteoid Osteoma, Osteoblastoma
      Histiocytosis X
      Leukemia, Lymphoma
      Osteosarcoma
      Ewing Sarcoma
      Spinal Cord Glioma
      Neuroblastoma
Congenital
      Tethered Cord

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