Screening

Red flags are signs & symptoms that might indicate serious pathology. In the cervical spine, following specific red flags will have to be excluded first, before you can continue with your patient history taking:

Red Flag Signs & Symptoms
Fractures Older age, (prolonged) use of corticosteroids, trauma in history, osteoporosis
Cervical Artery Dysfunction (CAD) Dizziness, diplopia, malaise, vomiting, extremity weakness, papillary changes
Spinal Cord Symptoms or Cervical Myelopathy Neurological symptoms, wide-spread neurological signs in both arms and/or legs such as changes of sensibility or weakness in legs+arms, bowel and bladder dysfunction
Infection (including urinary tract infections and skin infections) Signs and symptoms of infection (Fever, nocturnal sweating) other risk factors for infections (e.g. underlying disease, immunosuppressives, open wounds, intravenous drug use, exposure to contagious diseases)
Malignant tumors Cancer in history, no improvement of complaints after treatment of four weeks, unexplained weight loss, >50 years of age, problems with swallowing, headache, vomiting
Systemic diseases (herpes zoster, ankylosing spondylitis, inflammatory arthritis, rheumatoid arthritis) Headache, fever, one-sided skin rash, burning pain, itch
Study          
KNGF (2016)
Comment: This guideline is only available in Dutch at the moment.