AI for GPs

According to international guidelines and literature, clinical evaluation of acute low back pain focuses on identifying red flags that indicate serious underlying conditions—predominantly cauda equina syndrome, spinal fracture, malignancy, and spinal infection—requiring urgent investigation and specialist referral.

• Cauda equina syndrome: Acute urinary retention, bowel or bladder incontinence, saddle or perineal anesthesia, loss of anal sphincter tone, and progressive or widespread motor and sensory deficits in the lower extremities are critical indicators, as described in international sources. • Spinal fracture: Major or blunt trauma, advanced age (such as age > 50 or > 70 years), prolonged systemic corticosteroid use, and localized contusion or abrasion are key red flags in international guidelines. • Malignancy: A personal history of cancer carries the highest predictive value for spinal malignancy, alongside unexplained weight loss, constant non-mechanical pain or nocturnal pain, failure of conservative therapy, and age over 50 years, according to international sources. • Spinal infection: In line with international guidelines, indicators include documented fever (≥ 38 °C), intravenous drug use, immunosuppression, indwelling catheters, and recent invasive procedures or infections.

While individual red flags often carry low standalone specificity, international sources describe that combinations of multiple red flags substantially increase the probability of serious spinal pathology.