PT  - JOURNAL ARTICLE
AU  - Eric Roger
AU  - Mervyn Letts
TI  - Sickle cell disease of the spine in children
DP  - 1999 Aug 01
TA  - Canadian Journal of Surgery
PG  - 289--292
VI  - 42
IP  - 4
4099  - http://canjsurg.ca/content/42/4/289.short
4100  - http://canjsurg.ca/content/42/4/289.full
SO  - CAN J SURG1999 Aug 01; 42
AB  - Objective: To determine the incidence of back pain in children admitted with sickle cell disease so as to increase awareness of this disease in black children presenting with back pain or discomfort.Design: A retrospective review.Setting: The Children’s Hospital of Eastern Ontario in Ottawa, a tertiary care, university affiliated centre.Patients: Thirty children were treated for active sickle cell disease between 1990 and 1996. Eleven (5 boys, 6 girls) suffered vascular-occlusive phenomena occurring in bone, referred to as “bony crises,” requiring a total of 49 admissions.Main outcome measures: Clinical manifestations of spinal involvement by sickle cell disease.Main results: The spine represented the second most common area of bone involvement (26%) exceeded only by the knee (35%). The vertebral level affected was lumbosacral in 66% of cases, followed by thoracic in 22% and cervical in only 12%. Eighty-six percent of the children with spinal pain were anemic upon presentation, 71% had an elevated leukocyte count, 15% were hyponatremic and 15% were hyperkalemic. Minimal physical signs in the spine were noted, other than a local tenderness over the spinous process in 71% and a decreased range of back motion in 17%.Conclusions: Sickle cell disease is becoming more common in Canada as a result of increasing immigration from African countries and should always be considered as a possible cause of back pain in a black child.