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Table 50-2

Acute Low Back Pain: Risk Factors for an Important Structural Cause

History
Pain worse at rest or at night
Prior history of cancer
History of chronic infection (especially lung, urinary tract, skin)
History of trauma
Incontinence
Age >70 years
Intravenous drug use
Glucocorticoid use
History of a rapidly progressive neurologic deficit
Examination
Unexplained fever
Unexplained weight loss
Percussion tenderness over the spine
Abdominal, rectal, or pelvic mass
Internal/external rotation of the leg at the hip; heel percussion sign
Straight leg- or reverse straight leg-raising signs
Progressive focal neurologic deficit