International Framework for Red Flags for Potential Serious Spinal Pathologies

J Orthop Sports Phys Ther. 2020 Jul;50(7):350-372. doi: 10.2519/jospt.2020.9971. Epub 2020 May 21.

Abstract

The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) led the development of a framework to help clinicians assess and manage people who may have serious spinal pathology. While rare, serious spinal pathology can have devastating and life-changing or life-limiting consequences, and must be identified early and managed appropriately. Red flags (signs and symptoms that might raise suspicion of serious spinal pathology) have historically been used by clinicians to identify serious spinal pathology. Currently, there is an absence of high-quality evidence for the diagnostic accuracy of most red flags. This framework is intended to provide a clinical-reasoning pathway to clarify the role of red flags. J Orthop Sports Phys Ther 2020;50(7):350-372. Epub 21 May 2020. doi:10.2519/jospt.2020.9971.

Keywords: cauda equina syndrome; clinical reasoning; malignancy; spinal fracture; spinal infection.

Publication types

  • Practice Guideline

MeSH terms

  • Adult
  • Aged
  • Back Pain / etiology
  • Clinical Decision Rules*
  • Clinical Reasoning*
  • Female
  • Humans
  • Male
  • Medical History Taking
  • Middle Aged
  • Patient-Centered Care
  • Physician-Patient Relations
  • Spinal Diseases / complications
  • Spinal Diseases / diagnosis*
  • Spinal Diseases / therapy