Alagheband Sharzad J, Clapp Adrianna D, Narducci Dusty M, Cudahy Ryan, Pujalte George
Department of Internal Medicine, Winthrop University Hospital, Mineola, USA.
Department of Family Medicine, Mayo Clinic, Jacksonville, USA.
Cureus. 2021 Mar 17;13(3):e13954. doi: 10.7759/cureus.13954.
Athletes in their teenage years can present to clinics with back pain, without any history of trauma. Many sports require repetitive spinal extension, which may be pertinent to the evaluation of back pain as a chief complaint. Musculoskeletal and neurologic examinations are crucial in the evaluation of athletes presenting with back pain. Most back pain cases are caused by benign conditions that resolve with conservative treatment. However, radiographic imaging may be appropriate to look for possible spondylolysis in teenage athletes who perform repetitive extension in their sports, and who present with a positive stork test on examination. Limbus vertebra is a condition that can be seen in asymptomatic patients but can also be associated with back pain. Nevertheless, a conservative approach is still appropriate in these cases, with escalation to further testing or imaging only considered for recalcitrant pain. Limbus vertebra is not well known by clinicians and can be misdiagnosed. Therefore, early recognition is crucial to potentially prevent an unnecessary cascade of increasing expenses related to time, effort, medications, and resources to find the diagnosis when conservative treatment is preferred.
十几岁的青少年运动员可能会在没有任何创伤史的情况下到诊所就诊，主诉背痛。许多运动都需要反复进行脊柱伸展，这可能与以背痛为主诉的评估有关。肌肉骨骼和神经系统检查对于评估出现背痛的运动员至关重要。大多数背痛病例是由良性疾病引起的，通过保守治疗可以缓解。然而，对于在运动中反复进行伸展动作且在检查中鹳试验呈阳性的青少年运动员，进行影像学检查以寻找可能的椎弓根峡部裂可能是合适的。椎体缘离断症是一种在无症状患者中也可见的情况，但也可能与背痛有关。尽管如此，在这些情况下，保守治疗方法仍然是合适的，只有在顽固性疼痛时才考虑进一步检查或影像学检查。临床医生对椎体缘离断症了解不多，可能会误诊。因此，早期识别对于潜在地避免在首选保守治疗时因时间、精力、药物和资源等方面不必要的费用增加而进行的一系列检查至关重要。
