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Table 1 Red Flags [17]

From: The appropriate use of radiography in clinical practice: a report of two cases of biomechanical versus malignant spine pain

HISTORY PHYSICAL EXAMINATION
Cancer Saddle anesthesia
Unexplained weight loss Loss of anal sphincter tone
Immunosuppression Major motor weakness in lower extremities
Prolonged use of steroids Fever
Intravenous drug use Vertebral tenderness
Urinary tract infection Limited spinal range of motion
Pain that is increased or unrelieved by rest Neurologic findings persisting beyond one month
Fever  
Significant trauma related to age (e.g., fall from a height or motor vehicle accident in a young patient, minor fall or heavy lifting in a potentially osteoporotic or older patient or a person with possible osteoporosis)  
Bladder or bowel incontinence  
Urinary retention (with overflow incontinence)