International framework for red flags for potential serious spinal pathologies

Laura M. Finucane, Aron Downie, Christopher Mercer, Susan M. Greenhalgh, William G. Boissonnault, Annelies L. Pool-Goudzwaard, Jason M. Beneciuk, Rachel L. Leech, James Selfe

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


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.
Original languageEnglish
Pages (from-to)350-372
Number of pages26
JournalJournal of Orthopaedic and Sports Physical Therapy
Issue number7
Early online date21 May 2020
Publication statusPublished - Jul 2020


  • cauda equina syndrome
  • clinical reasoning
  • malignancy
  • spinal fracture
  • spinal infection


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