back pain- child

Question 1

variant 1
Child. Back pain with none of the following clinical red flags: constant pain, night pain,
radicular pain, pain lasting >4 weeks, abnormal neurologic examination. Initial imaging
evaluation.

Answer 1

imaging not indicated

Question 2

variant 2
Child. Back pain with 1 or more of the following clinical red flags: constant pain, night pain,
radicular pain, pain lasting >4 weeks, abnormal neurologic examination. Initial imaging
evaluation.

Answer 2

1. XR (green)
2. MRI complete spine without contrast (yellow
3. MRI complete spine with and without contrast (yellow)

Question 3

variant 3
Child. Back pain with 1 or more of the following clinical red flags: constant pain, night pain,
radicular pain, pain lasting >4 weeks, abnormal neurologic examination. Negative
radiographs.

Answer 3

1. MRI without contrast (green)

yellow

2. mri with and without contrast
3. ct without contrast
4. bone scan whole body SPECT or SPECT/CT complete spine

Question 4

variant 4
Child. Back pain with 1 or more of the following clinical red flags: constant pain, night pain,
radicular pain, pain lasting >4 weeks, abnormal neurologic examination. Positive
radiographs.

Answer 4

1. MRI complete spine without contrast (green)
2. MRI complete spine with and without contrast (greeb)

yellow

3. CT without contrast
4. Bone scane whole body with SPECT or SPECT/CT

Question 5

variant 5

Child. Chronic back pain associated with overuse. Mechanical back pain.

Answer 5

1. XR spine area of interest (green)
2. mri without contrast (green)

yellow
3. ct without contrast
bone scan SPECT