Red Flags for Four Serious Spinal Disorders
- RRS Education
Red flags are used by clinicians in many disciplines to identify if serious pathology may be the underlying cause of the patient’s musculoskeletal presentation. Depending on the practice setting, the prevalence of serious spinal pathology will vary. For example, a spine surgeon will (at least in theory) see a greater number of serious pathologies than a general practitioner. Unfortunately, confusion has persisted amongst clinicians, since recommendations regarding which specific red flags that should be considered are not consistent across guidelines. For spinal pathology specifically, the literature has reported 163 signs and symptoms as red flags, consisting of 119 symptoms from the individual’s history and 44 signs from the physical examination – quite a big list!
Despite red flag screening and tests lacking high-quality evidence for their diagnostic accuracy, their combination with an in-depth history and physical examination remain the best tools health care practitioners have to raise their suspicion of a serious spinal pathology.
The aim of this clinical position statement/framework is to provide clinicians with a standardized and consistent approach to identify, assess and provide initial management for four key spinal pathologies: Cauda equina syndrome, spinal fracture, spinal malignancy and spinal infection.
THIS WEEK'S RESEARCH REVIEW: “Red Flags for Four Serious Spinal Disorders”
This paper was published in the Journal of Orthopaedic & Sports Physical Therapy (2020) and this Review is posted in Recent Reviews, Low Back Pain, Geriatrics and the 2020 Archive.