Red Flags for Spinal Cancer in Low Back Pain

Physical therapists and physical therapist assistants who see people with low back pain in outpatient, direct-access, hospital, or emergency settings and want a plain-language account of what the screening evidence for spinal malignancy currently supports.

Physical therapists and physical therapist assistants

Intended audience

Physical Therapy

Level

Introductory

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course is based on a single open-access publication:

Notarangelo, G.; Margelli, M.; Giovannico, G.; Bruno, F.; Milella, C.; Feller, D.; Dunning, J.; Storari, L.; Mourad, F.; Maselli, F. Diagnostic Utility of Red Flags for Detecting Spinal Malignancies in Patients with Low Back Pain: A Scoping Review. Journal of Clinical Medicine 2025, 14, 7174.

All findings, figures, and conclusions presented in this course come from that scoping review. No outside claims have been added.

After completing this course, you will be able to:

1. Describe what the scoping review set out to map and which kinds of studies made up most of its evidence base.
2. Name the red flag that showed the most consistent diagnostic value across the included studies, and state how the review characterized the value of red flags for ruling in versus ruling out malignancy.
3. Explain the main limitations the authors identified in the current red flag literature and what they concluded about using red flags in combination.

1. Start Here: how this course works
2. Podcast: Red Flags and Spinal Cancer — What the Review Found (about nine minutes)
3. Cancer as a Cause of Low Back Pain: The Question Behind the Review
4. How the Reviewers Gathered and Sorted the Evidence
5. History of Cancer and the Rest: What the Red Flags Delivered
6. Where the Evidence Runs Thin
7. Ruling In Rather Than Ruling Out: What the Authors Concluded for Clinicians
8. Key Takeaways
9. Post-test and course evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course is based on a single open-access publication:
2. Notarangelo, G.; Margelli, M.; Giovannico, G.; Bruno, F.; Milella, C.; Feller, D.; Dunning, J.; Storari, L.; Mourad, F.; Maselli, F. Diagnostic Utility of Red Flags for Detecting Spinal Malignancies in Patients with Low Back Pain: A Scoping Review. Journal of Clinical Medicine 2025, 14, 7174.
3. All findings, figures, and conclusions presented in this course come from that scoping review. No outside claims have been added.