Nine cases of adolescent back pain show that a diagnosis of spondylolysis cannot be made on physical examination alone and that single photon emission computed tomography (SPECT) scanning revealed pars interarticularis stress lesions undiagnosable on planar technetium-99 bone scan. As management of spondylolysis differs from other lumbar dysfunctional problems SPECT scanning of children should be a sine qua non in extension related back pain with a normal radiograph and planar bone scintigraphy.
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