Olivella G, Deliz-Jimenez D, Lindsay E, Burgos-Rossy E, Torres-Acevedo N, Ramírez-Roggio D, Benítez-Gándara G, Ramírez N. Assessing need for advance imaging among children with back pain using pain intensity as clinical marker.
J Child Orthop 2022;
16:461-465. [PMID:
36483650 PMCID:
PMC9723860 DOI:
10.1177/18632521221137392]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/19/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION
Pediatric back pain evaluation nowadays relies on patient history, physical examination, and plain radiographs to identify underlying pathologies. Constant pain, night pain, radicular pain, and abnormal neurological examination were previously recommended as clinical markers to assess the need for magnetic resonance imaging evaluation. Recent studies have challenged the use of these clinical markers, recommending further studies. This study aimed to assess pain intensity as a predictor of underlying magnetic resonance imaging pathology in children with back pain.
METHODS
An observational cross-sectional study of pediatric patients between 8 and 17 years with back pain for more than 4 weeks from 2009 to 2021 was conducted. A whole spine magnetic resonance imaging was performed on patients with back pain without an identifiable cause and no prior spine treatment. The numerical rating scale questionnaire was administered to each patient, and answers were divided into three groups: mild (1-3), moderate (4-6), and severe (7-10) numerical rating scale score. Student's t-test and chi-square analysis were used to correlate differences between continuous and categorical values, respectively.
RESULTS
Of 590 patients (70% female and a mean age of 15.25 years), there were 35.1% of patients had a magnetic resonance imaging underlying pathology. No association was found between severe numerical rating scale score and the presence of underlying MRI pathology (p = 0.666). Patients with low or moderate numerical rating scale scores had similar associations to an underlying magnetic resonance imaging pathology as patients with a severe numerical rating scale score (p = 0.256; p = 0.357, respectively).
CONCLUSIONS
Back pain intensity was not found to be an effective clinical marker for predicting underlying magnetic resonance imaging pathology in pediatric patients with back pain.
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