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Br J Sports Med. 2014 Oct;48(20):1518. doi: 10.1136/bjsports-2014-f7095rep.

Red flags to screen for malignancy and fracture in patients with low back pain.

Author information

1
George Institute for Global Health, University of Sydney, Sydney, NSW, 2050, Australia Faculty of Science, Macquarie University, Sydney, Australia.
2
George Institute for Global Health, University of Sydney, Sydney, NSW, 2050, Australia.
3
George Institute for Global Health, University of Sydney, Sydney, NSW, 2050, Australia Institute of Public Health, University of Heidelberg, Germany.
4
Faculty of Human Sciences, Macquarie University, Sydney, Australia.
5
Department of Health Sciences, EMGO Institute for Health and Care Research, VU University, Amsterdam, Netherlands.
6
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam.
7
Screening and Test Evaluation Program (STEP), School of Public Health, Sydney.
8
School of Public Health, University of Sydney, Sydney, Australia.
9
Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, Netherlands.
10
Department of General Practice, Erasmus Medical Centre, Rotterdam, Netherlands.

Abstract

STUDY QUESTION:

What are the best red flags to indicate the possibility of fracture or malignancy in patients presenting with low back pain in primary, secondary, or tertiary care?

SUMMARY ANSWER:

Older age, prolonged corticosteroid use, severe trauma, and presence of a contusion or abrasion increase the likelihood of spinal fracture (likelihood was higher with multiple red flags); a history of malignancy increases the likelihood of spinal malignancy.

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