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Persistent back pain in the absence of clear red flags
  1. Christopher C Ledford1,2,
  2. Colin Linthicum2
  1. 1Department of Family Medicine, UNC Chapel Hill, Chapel Hill, North Carolina, USA
  2. 2Department of Family Medicine, Ft Belvoir Community Hospital, Fort Belvoir, Virginia, USA
  1. Correspondence to Dr Christopher C Ledford, chrisledford97{at}


A 62-year-old woman with low back pain was eventually diagnosed with vertebral osteomyelitis after multiple visits to emergency, primary and specialty care. The absence of traditional ‘red flags’ from her history and examination serves as an important reminder that their absence does not necessarily reflect benign pathology.

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