Back pain as the presenting symptom in juvenile dermato/polymyositis

Juvenile dermato/polymyositis is an inflammatory myopathy that usually presents with symmetrical hip and shoulder girdle muscle weakness, with or without a skin rash. In our series of 78 patients with dermato/polymyositis, we found eight children whose initial complaint was back pain, a rare symptom at the onset of other pediatric rheumatic diseases. This unusual presentation significantly delayed the correct diagnosis in most of our cases.