Musculoskeletal Pain as an Indicator of Occult Malignancy

about their care, even when faced with a serious diagnosis. Shared decision making is essential to ensure that individuals are supported to make decisions that are right for them. Using a collaborative process, the clinician should highlight the treatment options, evidence, risks, and benefits and, together with the person, seek to understand how these fit with that person's circumstances, goals, values, and beliefs. 56

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“…66 Malignancy as a cause of musculoskeletal pain is estimated at 7.0% in the secondary care setting. 40…”

Section: Spinal Malignancymentioning

confidence: 99%

International Framework for Red Flags for Potential Serious Spinal Pathologies

Finucane

Downie

Mercer³

et al. 2020

J Orthop Sports Phys Ther

147

132

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“…Two systematic reviews [42,45], including six primary studies [88,90,91,[93][94][95] provided data on the diagnostic value of demographics for the diagnosis of spinal malignancy (see Table S14). The most reported index test was "Age greater than 50 years", being investigated by five primary studies.…”

Section: Malignancymentioning

confidence: 99%

Diagnosis Value of Patient Evaluation Components Applicable in Primary Care Settings for the Diagnosis of Low Back Pain: A Scoping Review of Systematic Reviews

Mathieu

Pasquier

Descarreaux

et al. 2023

JCM

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Low back pain ranks as the leading cause of years lived with disability worldwide. Although best practice guidelines share a consistent diagnostic approach for the evaluation of patients with low back pain, confusion remains as to what extent patient history and physical examination findings can inform management strategies. The aim of this study was to summarize evidence investigating the diagnostic value of patient evaluation components applicable in primary care settings for the diagnosis of low back pain. To this end, peer-reviewed systematic reviews were searched in MEDLINE, CINAHL, PsycINFO and Cochrane databases from 1 January 2000 to 10 April 2023. Paired reviewers independently reviewed all citations and articles using a two-phase screening process and independently extracted the data. Of the 2077 articles identified, 27 met the inclusion criteria, focusing on the diagnosis of lumbar spinal stenosis, radicular syndrome, non- specific low back pain and specific low back pain. Most patient evaluation components lack diagnostic accuracy for the diagnosis of low back pain when considered in isolation. Further research is needed to develop evidence-based and standardized evaluation procedures, especially for primary care settings where evidence is still scarce.

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