Whilst discogenic back pain, sprains and strains can occur in children, back pain in children is a red flag for potential underlying significant pathology such as osteoid osteomas, spondylolysis or spondylolisthesis, infection or malignant tumours of the spine. As such the threshold for MRI imaging of back pain in children is low.
Referrals for back pain in children should be made to the Children’s Orthopaedic Service. Check for scoliosis or kyphosis in adolescents as these can be painful and easy to identify on exam.