W1: Prep

Question 1

What are the challenges associated with using red flags in clinical practice?

Answer 1

There is a lack of high quality evidence for their diagnostic accuracy

Question 2

What are the three steps included in the decision tool for early identification of serious spinal pathology?

Answer 2

• Determine level of concern
• Decide clinical action
• Consider emergency/urgent referral

Question 3

How should clinicians determine their level of concern regarding serious spinal pathology?

Answer 3

By considering the evidence for red flags and the individuals health profile

Question 4

What are the four key spinal pathologies prioritised by the framework?

Answer 4

Cauda equina syndrome
Spinal fracture
Malignancy
Spinal infection

Question 5

What features are associated with cauda equina syndrome?

Answer 5

Unilateral or bilateral radicular pain
Saddle anesthesia
Bladder dysfunction

Question 6

What features are associated with spinal fractures?

Answer 6

Prolonged corticosteroid use
Tenderness to palpation
History of trauma
Osteoporosis

Question 7

What features are associated with spinal infections?

Answer 7

Intravenous drug use
Immunosuppression
Fever
Recent infection

Question 8

Why is it important to involve patients in decision making when there is suspicion of serious pathology?

Answer 8

To ensure that patients are fully informed and supported in their care decisions

Question 9

How can clinicians provide effective communication about red flags to patients?

Answer 9

By clearly explaining the reasons for assessing red flags and providing reassurance

Question 10

What are the key clinical messages regarding the use of red flags in practice?

Answer 10

There is a lack of evidence for most red flags, combinations of red flags are more informative and they should be used within a clinical examination

Question 11

What are the four main exercise prescription for thoracic pain?

Answer 11

Mobility (ROM)
Motor control
Work capacity
Strength