Abstract
Purpose
To question the reliability of Thoracic Spine pain as a red flag and symptoms of a possible cause of Serious Spinal Pathology (SSP).
Methods
The clinical notes and Magnetic Resonance Imaging (MRI) results of patients presenting to the Sheffield Spinal Service with Thoracic spine symptoms but no signs were retrospectively reviewed over the period of 2 year (September 2008-August 2010).
The clinical reason for request of Thoracic MRIs were noted and the patient notes were reviewed to determine their presentation, length of time of symptoms, age and also it was noted whether any other recognized red flag symptoms were present. Exclusion criteria consisted of patients referred with known SSP or myelopathic symptoms.
Results
57 thoracic spine MRI requests were made in total by the orthopaedic spinal teams for patients presenting with thoracic spine pain in the time period. 8 patients were excluded as per criteria as they were referred with known SSP as were 4 other patients with a history of previous cancer. 45 patients presented with thoracic spine pain but no other red flag signs or symptoms of these none had MRI evidence of serious spinal pathology or indeed anything pathological indicating the cause of their symptoms.
Conclusion
The majority of those presenting to orthopaedic spinal clinic with thoracic spine pain alone with no other red flag signs have no pathological cause. Thoracic pain is a widely accepted indicator (red flag) of potential serious spinal pathology. The findings from this review would not support thoracic pain alone as an indicator of SSP.
