Low back pain in a teenager rare cause – Morquios syndrome

Teenage children presenting with back pain is unusual. Back pain due to musculoskeletal cause varies from mechanical pathologies, juvenile spondyloarthritis, biomechanical strain and metabolic causes like osteomalacia/rickets. Skeletal dysplasia is uncommon in general population and metabolic bone diseases usually manifest in childhood. Rare genetic diseases are increasingly identified because of definite genetic studies and inheritance. Mucopolysaccharidosis is one among the metabolic bone diseases where genetic defect causes enzyme deficiency thereby resulting in accumulation of glycosaminoglycans in the cell, accounting for the skeletal and systemic manifestations. Unrecognized patients may mimic as juvenile spondyloarthritis or JIA. Hence it’s important to recognise these unusual features but mimics as classic patients with arthritis, which would help the patient enormously.