Diagnostic and therapeutic problems of back pain syndromes and their distribution according to a colour coding system of flags.

BACKGROUND Back pain poses a serious clinical problem in some cases, because under the clinical symptoms of back pain might be other hidden diseases. The aim of this study was to present difficulties in diagnosis and treatment of various diseases of the spine and 2. description to the flagship division, based on the traffic lights. MATERIALS AND METHODS The clinical material is based on a group of 20 patients with diagnostic and therapeutic difficulties, among 1825 patients treated due to low back pain. Diagnosis was based on clinical examination and various imaging techniques. In the case of cancer biopsy was performed, and in specific and nonspecific infections of the spine treated surgically toward the microscopic examination of tuberculous granulation tissue or inflammatory. The diagnosis of osteoporotic fractures was based on the digital 3D CT. The studied group of 20 patients were divided according to color flag system. RESULTS Among the analyzed patients 14 received red flag, 5 yellow and 1 black. The red flag has received seven patients with spinal infection, 3 patients with cancer and two with osteoporotic fracture, and 2 patients with low back pain due to an aortic aneurysm. Yellow flag received 5 patients with compensation claims. CONCLUSIONS 1. In patients with back pain, diagnostic examinations should be administered according to a particular order. Clinical and radiographic examinations are basic tools which should be supplemented by the modern techniques of MRI and CT. 2. Histopathological evaluation of tissue preparations facilitates the diagnosis of an infection or tumour. 3. Classification according to colored flags are useful in clinical practice. It describes the degree of risk of serious illness and difficulties in therapy.