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12 year old with painless bruises on the lower spine. Need an immediate X-ray?

My 12 year old daughter has bruise type marks on her lower spine. I went to the doctors yesterday and they asked her a few questions:
1. Did the area cause her any pain? She said no
2. Was she having any problems going to the toilet, like doing wees and poos? She said no
3. Did she have any incontinence problems? She said no
I noticed the marks a few months ago and thought it was from when her and her sister were piggy backing each other and assumed she got them from that. But the bruises are still there. She doesn't complain about them and they don't cause her any pain. The doctor mentioned to keep an eye on it and if she gets any pain I was to go and get an x-ray. I have been up worrying most of the night. Should I go back to the doctors and ask for an x-ray just to be on the safe side?
Asked On : Fri, 19 Apr 2013
Answers:  1 Views:  531
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General & Family Physician 's  Response
Hello and welcome to HCM.

Thank you for your query.

A bruise-like discoloration in the lower (lumbar) spine region could point towards a number of conditions. Let me first list them out for you and then accordingly guide you into finding the cause. They are:
-Bruise (which should have disappeared by now)
-Muscle strain (requires rest and no strain)
-Hematoma (collection of blood; can be drained if present)
-Whiplash injury (is a serious injury)
-Stones in renal tract
-Other kidney disorders or infections even leading to kidney failure
-Direct injury
-Bone infection (osteomyelitis)
-Thrombocytopenia (low platelet count)
-Fracture of the spine (will severely affect mobility)
-Severe pulmonary insufficiency (will also have serious breathing difficulties)
-Skin disorders
-Infections in surrounding organs
-Herpes zoster infection
-Tetanus (serious)

As this has already lasted for more than a few months, I do not see why we should delay any further. Please go about an elaborate examination of the region with an x-ray to start off with, blood parameters (with emphasis on renal profile), get the region examined by a skin specialist (dermatologist), an ultrasound of the region along with of the abdomen and pelvis.

Please go ahead with the above mentioned investigations at the earliest. I hope and pray your daughter is fine and that this bruise-like rash dissapears naturally.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you.

Best wishes.
Answered: Fri, 19 Apr 2013
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