A 61 year old gentleman presents to the Emergency Department with acute lower back pain. The pain began suddenly 1 day ago with no history of trauma, lifting or strain to the back.

The pain is generally worse at rest. The pain is limited specifically to the lumbar spine. He states he feels his walking has gotten worse and that his legs feel a little weak. He denies any long term drug use. He reports he was treated for bowel cancer some 15 years ago, but received the all clear many years ago and is under no active follow up. He is otherwise fit and well, doesn't smoke and only takes occasional alcohol.


Answer one question before attending the face-to-face teaching session. Add comments to answers already given if you think it's appropriate. The first part of teaching will be spent discussing this case:

  1. What further history points would you like to clarify from this gentleman and why?

  2. What examinations would you like to perform and why?

  3. What are the red flag features of this man's pain?

  4. What are yellow flag features of back pain?

  5. What are blue flag features of back pain?

  6. How would initially investigate this patient?

  7. Considering the most likely diagnosis, how could this patient be managed initially in the Emergency Department?