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Back Pain: HELP
Articles by Susan Palasis
Based on 1 article published since 2009
(Why 1 article?)

Between 2009 and 2019, Susan Palasis wrote the following article about Back Pain.
+ Citations + Abstracts
1 Guideline ACR Appropriateness Criteria 2017

Anonymous3670905 / Booth, Timothy N / Iyer, Ramesh S / Falcone, Richard A / Hayes, Laura L / Jones, Jeremy Y / Kadom, Nadja / Kulkarni, Abhaya V / Myseros, John S / Partap, Sonia / Reitman, Charles / Robertson, Richard L / Ryan, Maura E / Saigal, Gaurav / Soares, Bruno P / Tekes-Brady, Aylin / Trout, Andrew T / Zumberge, Nicholas A / Coley, Brian D / Palasis, Susan. ·Principal Author, Children's Medical Center, Dallas, Texas. Electronic address: tim.booth@childrens.com. · Co-Author, Seattle Children's Hospital, Seattle, Washington. · Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; American Pediatric Surgical Association. · Children's Healthcare of Atlanta, Atlanta, Georgia. · Texas Children's Hospital, Houston, Texas. · Emory University and Children's of Atlanta (Egleston), Atlanta, Georgia. · Hospital for Sick Children, Toronto, Ontario, Canada, neurosurgical consultant. · Children's National Medical Center, Washington, District of Columbia, neurosurgical consultant. · Stanford University, Stanford, California; American Academy of Pediatrics. · Medical University of South Carolina, Charleston, South Carolina; North American Spine Society. · Boston Children's Hospital, Boston, Massachusetts. · Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. · Jackson Memorial Hospital, Miami, Florida. · Johns Hopkins University School of Medicine, Baltimore, Maryland. · Johns Hopkins Medical Institute, Baltimore, Maryland. · Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. · Nationwide Children's Hospital, Columbus, Ohio. · Specialty Chair, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. · Panel Chair, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia. ·J Am Coll Radiol · Pubmed #28473069.

ABSTRACT: It is now generally accepted that nontraumatic back pain in the pediatric population is common. The presence of isolated back pain in a child has previously been an indication for imaging; however, recently a more conservative approach has been suggested using clinical criteria. The presence of constant pain, night pain, and radicular pain, alone or in combination, lasting for 4 weeks or more, constitute clinical red flags that should prompt further imaging. Without these clinical red flags, imaging is likely not indicated. Exceptions include an abnormal neurologic examination or clinical and laboratory findings suggesting an infectious or neoplastic etiology, and when present should prompt immediate imaging. Initial imaging should consist of spine radiographs limited to area of interest, with spine MRI without contrast to evaluate further if needed. CT of the spine, limited to area of interest, and Tc-99m bone scan whole body with single-photon emission computed tomography may be useful in some patients. The addition of intravenous contrast is also recommended for evaluation of a potential neoplastic or infectious process. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.