International Framework for Red Flags for Potential Serious Spinal Pathologies

TLDR

Serious spinal pathology is rare but can cause life‑changing consequences, and clinicians have historically used red flags to identify it, yet high‑quality evidence for their diagnostic accuracy is lacking. The framework offers a clinical‑reasoning pathway to clarify the role of red flags in assessing patients at risk of serious spinal pathology. Published in J Orthop Sports Phys Ther 2020;50(7):350–372 (Epub 21 May 2020; doi:10.2519/jospt.2020.9971).

Abstract

Synopsis 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