A 17-year-old female student presented with long-standing dull dorsolumbar pain that had increased recently as she spent more time sitting and studying. Physical examination revealed pain with trunk flexion but no other abnormalities. Ibuprofen provided only partial pain relief. X-rays showed loss of vertebral body height, kyphosis, and irregular vertebral endplates consistent with Scheuermann's disease.

1. Teen with lumbar back
pain
Luis Daniel Ruiz Hernández
Sección 206

2. This is a female patient of 17 years old with no history of
interest, she's a student, who goes to her family doctor for
unirradiated dorsolumbar pain and mechanical qualities of
years of evolution, unrelated to exertion or trauma. The pain
doesn't limit their activities of daily living nor interferes with
sleep .She had not previously consulted, but now she stays a
long time sitting, while she's studying and the pain has
increased.
On physical examination , there aren't pain spots selective in
dorso- lumbar region. Pain is reproduced with trunk flexion,
being general in the area. The hip is not painful to
mobilization . The Lassegue is negative and tendon reflexes
are normal.

3. The doctor prescribed Ibuprofen 400mg/8 hours for a week
and he told her that she should go back if she no
improvement . A week later, the patient returned because the
pain subsides only partially with NSAID . No changes in the
pattern of pain or on physical examination . Paracetamol is
added and Rx thoracolumbar spine is requested.

4. In Figure 2 , It can observed
several loss of height of
vertebral bodies lower
thoracic, lower thoracic
kyphosis and irregular
surfaces upper and lower of
vertebral bodies .

5. In Figure 1 , it can observed
compensatory lumbar
lordosis, unaltered in the
morphology of the vertebral
bodies. With clinical and
radiological findings , the
patient was diagnosed
Scheuermann 's Disease (ES
) or juvenile idiopathic
kyphosis.