E Osteogenic sarcoma F Osteoblastoma G Neuroblastoma H Wilms tumor V Other A Sickle cell disease B Nephrolithiasis C Urinary tract obstruction D Scheuermann kyphosis E Aortic dissection F Imperforate hymen with hematocolpos G Chronic pain syndrome H Psychogenic TABLE 54.2 RED FLAGS FOR PEDIATRIC PATIENTS WITH BACK PAIN History Direct or repetitive trauma Constant pain or night-time pain Pain that improves with movement Young age Fever Incontinence Weakness Numbness Intravenous drug use Chronic steroid use History of tuberculosis exposure Physical Weakness Anal sphincter weakness Saddle anesthesia Abnormal deep tendon reflexes Spinal tenderness