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There is a wide spectrum of causes of back pain.

Scoliosis (lateral curve of the spine) has a range of causes.  A painful scoliosis is a red flag for serious conditions and urgent referral is needed.

Infections such as vertebral osteomyelitis and Tuberculosis (TB) may present with backache and need to be excluded in endemic regions.

Mechanical back pain is common and associates with poor posture, physical inactivity, overweight, or abnormal loading (such as carrying heavy school bags on one shoulder). 

Certain sporting activities such as cricket, bowling or gymnastics pose increased risk of back pain, with possible consequences such as spondylolysis and spondylolisthesis which present as acute, or acute on chronic pain with localised tenderness.

Scheuermann’s 'disease' is often a coincidental finding on radiograph. It results from vertebral wedging due to an osteochondosis of the thoracic spine and can result in thoracic kyphosis and a 'slouching appearance'.

Inflammatory back pain (often with morning stiffness) can be a feature of Juvenile Idiopathic Arthritis (often in older children and adolescents) and also arthritis in association with inflammatory bowel disease. 

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