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MRI indications for Low Back Pain LBP MRI Guidelines: Assessment Tools Red flags & investigation to consider <table><tr><td>Symptoms</td><td>Investigation</td></tr><tr><td>Neurological: diffuse motor/sensory loss, progressive neurological deficits, cauda equina syndrome</td><td>Urgent MRI indicated</td></tr><tr><td>Infection: fever, IV drug use, immune suppressed</td><td>X-ray and MRICBC, ESR, CRP</td></tr><tr><td>Fracture: trauma, osteoporosis risk/fragility fracture</td><td>X-ray and may require CT scan</td></tr><tr><td>Tumor: history of cancer, unexplained weight loss, significant unexpected night pain, severe fatigue</td><td>X-ray and MRIReferral to Oncology for cytology</td></tr><tr><td>Inflammation: chronic low back pain >3 months, age of onset <45, morning stiffness >30 minutes, pain improve with exercise.</td><td>Rheumatology Consultation, ANA, RF, CBC, CRP,ESR</td></tr></table> Resources 1- Bury, Martin Army Community Hospital, Fort Benning, Georgia, Am Fam Physician. 2018 Oct 1;98(7):421-428, https://www.aafp.org/afp/2018/1001/p421.html 2- American College of Radiology ACR Appropriateness Criteria® Low Back Pain https://acsearch.acr.org/docs/69483/Narrative/ 3 Diagnosis and Treatment of Acute Low Back Pain https://www.aafp.org/afp/2012/0215/p343.html 4 Mai, Volume 10, Issue 4, December 2020, Pages 269 _ = 275 , https://www.atlantis-press.com/journals/jegh/125938834/view 5 Marks, August 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3414626/ 6Ninds, 2020-04-27, How back pain treated, https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet_7-Daniel, 2020, red flags and yellow flags, https://radiopaedia.org/articles/red-and-yellow-flags-for-guiding-imaging-of-lower-back-pain