Template:Back pain red flags: Difference between revisions

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| align="center" style="background:#f0f0f0;"|'''Factor'''
| align="center" style="background:#f0f0f0;"|'''Factor'''
| align="center" style="background:#f0f0f0;"|'''Post Test Probability'''
| align="center" style="background:#f0f0f0;"|'''Post Test Probability''' (95%CI)
|-
|-
| Older Age  (>65yo) ||'''9%'''  
| Older Age  (>65yo) ||'''9%''' (3-25%)
(95% CI 3% to 25%)
|-
|-
| Prolonged corticosteroid||'''33%'''
| Prolonged corticosteroid||'''33%''' (10-67%)
(95% CI 10% to 67%)
|-
|-
| Severe trauma||'''11%'''  
| Severe trauma||'''11%''' (8-16%)
(95% CI 8% to 16%)
|-
|-
| Presence of contusion or abrasion||'''62% '''
| Presence of contusion or abrasion||'''62% ''' (49-74%)
(95% CI 49% to 74%)
|-
|-
| Multiple red flags||'''90%'''  
| Multiple red flags||'''90%''' (34-99%)
(95% CI 34% to 99%)
|-
|-
| Hx of malignancy||'''33%'''  
| History of malignancy||'''33%''' (22-46%)
(95% CI 22% to 46%)
|}
 
===Red Flag Symptoms of Low Back Pain <ref>Depalma. Red flags of low back pain. JAAPA. 2020;33(8):8. doi:10.1097/01.JAA.0000684112.91641.4c</ref>===
 
{| class="wikitable"
|+
|-
! Symptoms !! Corresponding Pathology
|-
| Age under 18 years || Congenital abnormality
|-
| Age over 50 years || [[Vertebral fractures and dislocations|Fracture]], malignancy
|-
| Anticoagulant use || [[Spinal hematoma]]
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| Fever || Infection, malignancy
|-
| Genitourinary issues including urinary retention/incontinence or sexual dysfunction || [[Cauda equina syndrome]]
|-
| Immunocompromised || [[Vertebral fractures and dislocations|Fracture]], infection
|-
| IV drug use || Infection
|-
| Recent spinal surgery or epidural injection || Infection, spinal hematoma
|-
| Trauma || [[Vertebral fractures and dislocations|Fracture]], [[spinal hematoma]]
|}
 
===Red Flag Signs of Low Back Pain<ref>Depalma. Red flags of low back pain. JAAPA. 2020;33(8):8. doi:10.1097/01.JAA.0000684112.91641.4c</ref>===
{| class="wikitable"
|+
|-
! Signs !! Corresponding Pathology
|-
| Reduced anal sphincter tone || [[Cauda equina syndrome]]
|-
| Hyperreflexia || [[Acute cord compression]]
|-
| Hyporeflexia/areflexia || [[Cauda equina syndrome]]
|-
| Lower extremity muscle weakness || [[Acute cord compression]] or [[Cauda equina syndrome]]
|-
| Saddle paresthesia/anesthesia || [[Cauda equina syndrome]]
|-
| Absent or decreased bulbocavernosus reflex || [[Cauda equina syndrome]]
|}
|}

Latest revision as of 15:57, 12 April 2023

Back Pain Risk factors and probability of Fracture or Malignancy[1]

Factor Post Test Probability (95%CI)
Older Age (>65yo) 9% (3-25%)
Prolonged corticosteroid 33% (10-67%)
Severe trauma 11% (8-16%)
Presence of contusion or abrasion 62% (49-74%)
Multiple red flags 90% (34-99%)
History of malignancy 33% (22-46%)

Red Flag Symptoms of Low Back Pain [2]

Symptoms Corresponding Pathology
Age under 18 years Congenital abnormality
Age over 50 years Fracture, malignancy
Anticoagulant use Spinal hematoma
Fever Infection, malignancy
Genitourinary issues including urinary retention/incontinence or sexual dysfunction Cauda equina syndrome
Immunocompromised Fracture, infection
IV drug use Infection
Recent spinal surgery or epidural injection Infection, spinal hematoma
Trauma Fracture, spinal hematoma

Red Flag Signs of Low Back Pain[3]

Signs Corresponding Pathology
Reduced anal sphincter tone Cauda equina syndrome
Hyperreflexia Acute cord compression
Hyporeflexia/areflexia Cauda equina syndrome
Lower extremity muscle weakness Acute cord compression or Cauda equina syndrome
Saddle paresthesia/anesthesia Cauda equina syndrome
Absent or decreased bulbocavernosus reflex Cauda equina syndrome
  1. ↑ Downie A, et al. Red flags to screen for malignancy and fracture in patients with low back pain: systematic review. BMJ. 2013; 347:f7095. [1]
  2. ↑ Depalma. Red flags of low back pain. JAAPA. 2020;33(8):8. doi:10.1097/01.JAA.0000684112.91641.4c
  3. ↑ Depalma. Red flags of low back pain. JAAPA. 2020;33(8):8. doi:10.1097/01.JAA.0000684112.91641.4c
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