by Dr. Dillon Cuppusamy

red-flag-image When you visit our clinic, the doctors will take a thorough history and perform a comprehensive examination. This is done in order to ensure our diagnosis for your case is accurate and the treatment is appropriate. Two aspects of your case we pay special attention to are red and yellow flags, which can be revealed at any point throughout your visit.

Clinical flags are common to many areas of health – for example, red flags for musculoskeletal disorders, which are indicators of possible serious pathology such as inflammatory or neurological conditions, structural musculoskeletal damage or disorders, circulatory problems, suspected infections, tumors or systemic disease.

All red flags, whether highly diagnostic or not, general or specific, presenting with drama or as sleepers, warn us of the possibility of disabling and life-threatening disorders. It’s important to remember that they only need to be sufficiently suggestive to compel us to rule out a serious condition to be a red flag, not absolutely diagnostic. Our goal is to identify the red flags and guide patients in the right direction.

If suspected, these require urgent further investigation and often surgical referral. There are certain signs and symptoms that when observed in a patient’s examination or history alert us to the fact that something could be seriously wrong. In the case of musculoskeletal disorders, the doctors at InTouch Clinic are highly trained to identify or rule out red flags.

General red flags are signs and/or symptoms that signal dangerous conditions with multiple possible explanations or that can manifest in many different anatomical areas. An example is a headache with a neurological deficit , which is a general red flag for some type of brain lesion, tumor, or bleeding, for example.

Specific red flags signal specific illnesses or are present in specific anatomical regions. An example is persistent double vision after a blow to an eye, which is a specific red flag for a blow-out fracture of the bones of the eye socket with the entrapment of muscle in the fracture.

General red flags are important, not for their specificity, but for their wide reach. No single text can cover all the red flags for every serious injury or illness. By knowing general red flags such as unexplained weight loss, however, the astute clinician can recognize when serious illness is likely to be present even if the exact illness is unknown. The ability to recognize general red flags is at least as important as being able to recognize specific red flags.

References:

Anzaldua D. 2010. An Acupuncturist’s Guide to Medical Red Flags and Referrals. 1st ed. Blue Poppy Enterprises Inc.

Henschke N, Maher CG, Refshauge KM, et al. 2009. Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain. Arth Rheumatology. 60:3072-80.

Leerar PJ, Boissonnault W, Domholdt E, Roddey T. 2007. Documentation of Red Flags by Physical Therapists for Patients with Low Back Pain. J Man Manipulative Therapy. 15(1): 42-49.

Sizer PS Jr, Brismee JM, Cook C. 2007. Medical screening for red flags in the diagnosis and management of musculoskeletal spine pain. Pain Pract. 7 (1):53-71.

Welch E. 2011. Red flags in medical practice. Clinical Medicine. 11 (3):251-253.

 

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