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Red Flags (Cervical Spine) (Cervical Myelopathy (Hoffman reflex, Unsteady…
Red Flags (Cervical Spine)
Fracture
Minor trauma in elderly patient
Ankylosing spondylitis
Clinically Relevant trauma in adolescent or adult
Infection
History of recent systemic infection
Recent invasive procedure
Unexplained weight loss
Immunosuppression
Fever, chills, night sweats
Intravenous drug use
Vertebral artery Insufficiency
Diplopia
Positive cranial nerve signs
Dysarthria
Dysphasia
Drop attacks
Dizziness or lightheadedness related to neck movement
Cervical Myelopathy
Hoffman reflex
Unsteady gait
Hyperreflexia
Muscle wastingof hand intrinsic muscles
Bowel and bladder disturbances
Sensory disturbance of the hands
Multisegmental weakness and/or sensory changes
Inflammatory or systemic disease
Fatigue
Resting respiration more than 25 bpm
Resting pulse more than 100 bpm
Blood pressure more than 160/95 mm Hg
Temperature more than 37ºC
Neoplasm
History of neoplasm
Age of more than 50 or less than 20 years
Unexplained weight loss
Previous history of cancer
Pain worse at night
Constant pain, no relief with bed rest
Upper Cervical Ligamentous Instability
Severe limitation during neck active ROM in all directions
Signs of cervical myelopathy
Occipital headache and numbness
Neurologic Injury
Progressive neurologic deficit
Upper and lower extremity symptoms
Bowel or bladder dysfunction
Magee, D. J. (2014). Orthopedic Physical Assessment. St. Louis, Mo: Saunders/Elsevier.