Red flags in back pain
Features, signs and symptoms in a patient with back pain which indicate serious spinal pathology.
History
- Previous history malignancy.
- Age 16< or >50 with NEW onset pain.
- Weight loss (unexplained).
- Previous longstanding steroid use.
- Recent serious illness.
- Recent significant infection.
Symptoms
- Non-mechanical pain (worse at rest)
- Thoracic pain
- Fevers/ rigors
- General malaise
- Urinary retention
Signs
- Saddle anaesthesia
- reduced anal tone
- hip or knee weakness
- generalised neurological deficit
- progressive spinal deformity
- urinary retention
investigations if not referring ASAP
- Myeloma screen.
- ESR, CRP, FBC, U+E, Calcium. PSA if suggestive.
- Plain xray.
- Consider MRI