15/09/2022, 13:06 RemNote
CHI337 / Spine pain triage CHI337 W7
Spine pain triage CHI337 W7
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A broad approach is to try and place a patient into one of the following categories:
1. Possible serious or ominous pathology (e.g. tumour, cauda equina syndrome)
2. Non-spinal pathology (e.g. visceral or vascular disease)
3. Problems related to radiculopathy/nerve compression (e.g. disc herniation with radiculopathy)
4. Benign spinal problems with no neurological feature
https://www.remnote.com/w/631fce5babbb359b0c8d5acc/Spine-pain-triage-CHI337-W7-XOemlBTTaaJqXUlMa 1/33
,15/09/2022, 13:06 RemNote
https://www.remnote.com/w/631fce5babbb359b0c8d5acc/Spine-pain-triage-CHI337-W7-XOemlBTTaaJqXUlMa 2/33
,15/09/2022, 13:06 RemNote
SERIOUS / NON-SPINAL PATHOLOGY
Serious pathology includes:
Cancer (primary or metastatic)
Infection (local or systemic)
Cauda equina syndrome
Cervical degenerative myelopathy
Vertebral or rib fractures
Spondyloarthropathies
Non-spinal pathology includes:
Vascular accidents (e.g. AAA, VAD)
Heart disease, myocardial infarction
Urinary tract infection
Endometriosis
SPINE PAIN RED FLAGS
https://www.remnote.com/w/631fce5babbb359b0c8d5acc/Spine-pain-triage-CHI337-W7-XOemlBTTaaJqXUlMa 3/33
, 15/09/2022, 13:06 RemNote
Cancer
More common in older populations or younger populations
M ay have a history of trauma at onset of spine pain
May cause spinal symptoms through local inflammation, stretching of vertebral periosteum, or
compression of nerve roots or the spinal cord
Can cause pathological fracture
May be a primary spine tumour or secondary (metastases)
Metastatic spine tumours are more common in older populations
Common sources of metastases to the spine are lung, breast, and prostate cancer
Primary spine tumours are more common in children
Red flag features that may be present:
Persistent, progressive pain
Pain that is worse at night, especially if waking them from sleep
https://www.remnote.com/w/631fce5babbb359b0c8d5acc/Spine-pain-triage-CHI337-W7-XOemlBTTaaJqXUlMa 4/33
CHI337 / Spine pain triage CHI337 W7
Spine pain triage CHI337 W7
Add Source Show Tags
View your shared article snapshot
A broad approach is to try and place a patient into one of the following categories:
1. Possible serious or ominous pathology (e.g. tumour, cauda equina syndrome)
2. Non-spinal pathology (e.g. visceral or vascular disease)
3. Problems related to radiculopathy/nerve compression (e.g. disc herniation with radiculopathy)
4. Benign spinal problems with no neurological feature
https://www.remnote.com/w/631fce5babbb359b0c8d5acc/Spine-pain-triage-CHI337-W7-XOemlBTTaaJqXUlMa 1/33
,15/09/2022, 13:06 RemNote
https://www.remnote.com/w/631fce5babbb359b0c8d5acc/Spine-pain-triage-CHI337-W7-XOemlBTTaaJqXUlMa 2/33
,15/09/2022, 13:06 RemNote
SERIOUS / NON-SPINAL PATHOLOGY
Serious pathology includes:
Cancer (primary or metastatic)
Infection (local or systemic)
Cauda equina syndrome
Cervical degenerative myelopathy
Vertebral or rib fractures
Spondyloarthropathies
Non-spinal pathology includes:
Vascular accidents (e.g. AAA, VAD)
Heart disease, myocardial infarction
Urinary tract infection
Endometriosis
SPINE PAIN RED FLAGS
https://www.remnote.com/w/631fce5babbb359b0c8d5acc/Spine-pain-triage-CHI337-W7-XOemlBTTaaJqXUlMa 3/33
, 15/09/2022, 13:06 RemNote
Cancer
More common in older populations or younger populations
M ay have a history of trauma at onset of spine pain
May cause spinal symptoms through local inflammation, stretching of vertebral periosteum, or
compression of nerve roots or the spinal cord
Can cause pathological fracture
May be a primary spine tumour or secondary (metastases)
Metastatic spine tumours are more common in older populations
Common sources of metastases to the spine are lung, breast, and prostate cancer
Primary spine tumours are more common in children
Red flag features that may be present:
Persistent, progressive pain
Pain that is worse at night, especially if waking them from sleep
https://www.remnote.com/w/631fce5babbb359b0c8d5acc/Spine-pain-triage-CHI337-W7-XOemlBTTaaJqXUlMa 4/33
