Extract
Even though primary infections and tumors of the spine are rare in
children, orthopaedic surgeons must be aware of the characteristic
presentation of these conditions to ensure a timely and appropriate workup.
The most common presenting symptom among this group of patients is back pain,
a ubiquitous and nonspecific complaint. Although the differential diagnosis
for children with back pain is broad, a higher index of suspicion should be
maintained for children than for adults because structural pathology is more
likely to be the cause of back pain in children. The information gained from a
detailed history and physical examination as well as from a careful assessment
of imaging studies usually enables a physician to narrow the differential
diagnosis and to suspect an infection or spinal tumor in children. A thorough
initial examination and early imaging studies facilitate the planning of
appropriate further work-up, imaging, biopsy, and management. When tumor or
infection is suspected, these steps should be done rapidly to prevent delays
that can decrease the likelihood of a satisfactory outcome and cause children
and families to worry unnecessarily about the possibility of a malignant
disease.