Dr. Holley will present data from her NIH-funded R01 (in final year) which recruits treatment-seeking youth with acute musculoskeletal pain and examines predictors of pain trajectories over 12 months (T1: <30 days post injury; T2: 4 month follow-up; T3 12 month follow-up). Participants (ages 11-17 years) are recruited from 2 children’s hospitals in the northwestern United States who presented to the emergency department or outpatient clinics for treatment of acute MSK pain. Data collection remains underway but preliminary data (below) for n=204 youth at T1 and n=189 at T2 is currently available. Pain location was 82% foot/leg, 29.4% experienced a fracture, and were 64.5% sports-related injuries. At T1 (<30 days post-injury) average pain intensity (M=3.11,SD=2.02; range 0-8) and pain with movement (M=4.20, SD=2.48; range 0-10) was moderate.  At T2 a significant portion of youth developed persistent pain. 23% reported clinically significant pain (≥ 3 NRS) with movement and 18.5% reported usual intensity ≥ 3 NRS. Planned data to be presented in the symposia will be psychosocial predictors of recovery and how screening tools used in the acute pain period can inform symptom management and identification of youth at risk for poor pain outcomes.