Red Flags in Musculoskeletal Care: What the Definition Problem Means for Screening and Referral

Physical therapists and physical therapist assistants working in outpatient orthopedics, primary contact and direct access settings, hospital-based rehabilitation, and academic or clinical education roles who encounter musculoskeletal complaints that may occasionally reflect serious underlying disease.

Licensed physical therapists and physical therapist assistants, along with students and clinical educators, who screen musculoskeletal presentations and participate in referral pathways. Physical therapist assistants provide care under the direction and supervision of a physical therapist; evaluation, differential diagnosis, and plan-of-care decisions remain with the physical therapist.

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

Storari, L.; Piai, J.; Zitti, M.; Raffaele, G.; Fiorentino, F.; Paciotti, R.; Garzonio, F.; Ganassin, G.; Dunning, J.; Rossettini, G.; Feller, D.; Heick, J.D.; Mourad, F.; Maselli, F. Standardized Definition of Red Flags in Musculoskeletal Care: A Comprehensive Review of Clinical Practice Guidelines. Medicina 2025, 61, 1002.

Open access under the Creative Commons Attribution (CC BY) license. Published by MDPI on behalf of the Lithuanian University of Health Sciences. This course reports what that review examined, what it found, what its authors proposed, and the limits the authors themselves described. It does not add claims from other sources.

After completing this course, you will be able to:

1. Describe how red flags were defined across the clinical practice guidelines and systematic reviews of guidelines included in this review, and where those definitions agreed and diverged.
2. State the unified definition of red flags proposed by the review authors and name the categories of serious pathology it explicitly references.
3. Explain the two limitations the authors identified in current red flag use: the accuracy of red flags as screening indicators, and the absence of guidance on how urgently a positive finding should be acted on.

1. Start Here: How This Course Works
2. Podcast: The Red Flag Definition Problem, Explained (about nine minutes)
3. Why the Definition of a Red Flag Came Under Review
4. How the Review Searched and Sorted the Guidelines
5. What the Guidelines and Reviews Actually Said
6. Where the Red Flag Concept Runs Out of Evidence
7. A Unified Definition and What It Could Change at First Contact
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. Storari, L.; Piai, J.; Zitti, M.; Raffaele, G.; Fiorentino, F.; Paciotti, R.; Garzonio, F.; Ganassin, G.; Dunning, J.; Rossettini, G.; Feller, D.; Heick, J.D.; Mourad, F.; Maselli, F. Standardized Definition of Red Flags in Musculoskeletal Care: A Comprehensive Review of Clinical Practice Guidelines. Medicina 2025, 61, 1002.
2. Open access under the Creative Commons Attribution (CC BY) license. Published by MDPI on behalf of the Lithuanian University of Health Sciences. This course reports what that review examined, what it found, what its authors proposed, and the limits the authors themselves described. It does not add claims from other sources.