Red flags
  • 01 Dec 2023
  • 1 Minute to read
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Red flags

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Article summary

The below are example red flags for musculoskeletal conditions. Other red flags can exist, and clinical acumen is required. If red flags are present, consider urgent referral or admission.

For more information on red flags, see NICE CKS links in the red box below.

Malignancy
  • Unremitting pain with disturbed sleep
  • Unexplained lump increasing in size
  • Unexplained bone swelling or pain
  • Previous malignancy
  • Unexplained weight loss or cachectic appearance
Neurological injury
  • Neurological symptoms or loss of function
  • Altered bladder or bowel habit
  • Bilateral sciatica
Infection
  • Fever or signs of joint infection
  • Loss of joint function
  • Immunocompromised
Fracture
  • Pinpoint tenderness over a vertebral body
  • History of trauma
  • Structural deformity of the spine
Inflammatory arthritis or PMR
  • Early morning stiffness +/- headache or jaw claudication
  • Raised inflammatory markers
  • Synovitis


NOTE:

For information on red flags, see:

  1. NICE CKS guidance. Suspected cancer and referral.
  2. NICE CKS guidance. Red flag signs and symptoms for radiculopathy.
  3. NICE CKS guidance. Chronic pain.

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