{"id":7870,"date":"2026-01-04T08:46:55","date_gmt":"2026-01-04T07:46:55","guid":{"rendered":"https:\/\/kineaphp.fr\/?p=7870"},"modified":"2026-01-04T08:46:55","modified_gmt":"2026-01-04T07:46:55","slug":"drapeaux-rouges-lombaires","status":"publish","type":"post","link":"https:\/\/kineaphp.fr\/?p=7870","title":{"rendered":"Drapeaux rouges lombaires"},"content":{"rendered":"\n

Les lombaires<\/h2>\n\n\n\n

Tumeur<\/h3>\n\n\n\n
– Ant\u00e9c\u00e9dent de cancer
– Perte de poids inexpliqu\u00e9e (5 \u00e0 10% en 3 \u00e0 6 mois)
– Douleur nocturne \/ au repos \/ multi-site
– Pas d\u2019am\u00e9lioration apr\u00e8s 4-6 semaines de traitement
– Age > 50 ans
– Autres : vitesse de s\u00e9dimentation \u00e9lev\u00e9e, malaise, app\u00e9tit r\u00e9duit, fatigue rapide, sympt\u00f4mes progressifs, fi\u00e8vre, paresth\u00e9sies<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Fracture<\/h3>\n\n\n\n
Cluster de Henschke<\/strong>
Risque (52%) fracture vert\u00e9brale chez patients souffrant d\u2019une lombalgie aigu\u00eb quand 3\/4 crit\u00e8res suivant sont positifs :
– femme
– \u00e2ge > 70 ans
– traumatisme significatif : majeur chez les jeunes et mineur chez les personnes \u00e2g\u00e9es (chute d\u2019une hauteur de 5 marches ou de 90cm)
– utilisation prolong\u00e9e de corticost\u00e9ro\u00efdes<\/td><\/tr>
Cluster de Roman<\/strong>
Risque (20%) fracture de compression vert\u00e9brale ost\u00e9oporotique, si douleur lombaire avec ou sans douleur dans le MI, si au moins 4 tests positifs :
– \u00e2ge > 52 ans
– pas de douleur dans les jambes
– IMC < 22
– pas d\u2019activit\u00e9 physique r\u00e9guli\u00e8re
– femme<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Infection<\/h3>\n\n\n\n
– Fi\u00e8vre \u2265 38 \u00b0C
– Utilisation de corticost\u00e9ro\u00efdes ou d\u2019immunosuppresseurs
– Abus de drogues intraveineuses \/ toxicomanie
– Immunod\u00e9ficience (SIDA)
– Infection urinaire
– Douleur nocturne intense
– Autres : chirurgie ant\u00e9rieure du dos, infection bact\u00e9rienne ant\u00e9rieure, plaie p\u00e9n\u00e9trante, app\u00e9tit r\u00e9duit, fatigue rapide<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Syndrome de la queue de cheval<\/h3>\n\n\n\n
FDR<\/strong>
Suspicion faible :<\/em>
– hernie discale (le plus souvent L4-L5 ou L5-S1, < 50 ans, ob\u00e9sit\u00e9)
– st\u00e9nose lombaire (personnes \u00e2g\u00e9es)
– chirurgie vert\u00e9brale<\/td><\/tr>
Sympt\u00f4mes<\/strong>
suspicion faible<\/em> :
– troubles sensitifs diffusant dans les membres inf\u00e9rieurs
– faiblesse musculaire progressive des membres inf\u00e9rieurs
– marche perturb\u00e9e
– troubles sensoriels
– anesth\u00e9sie en selle \/ engourdissement p\u00e9ri-anal
– changement dans la capacit\u00e9 \u00e0 obtenir une \u00e9rection ou \u00e0 \u00e9jaculer
– perte de sensations dans les parties g\u00e9nitales lors de rapports sexuels
– troubles des fonctions urinaires soudaine (fr\u00e9quence, r\u00e9tention ++, incontinence)
– troubles intestinaux (incontinence f\u00e9cale, constipation)
– douleur des membres inf\u00e9rieurs unilat\u00e9rale\/bilat\u00e9rale
– douleur lombaire<\/td><\/tr>
Signes<\/strong>
suspicion faible :<\/em>
– anesth\u00e9sie en selle au toucher et \u00e0 la piq\u00fbre (\u00e9pingle)
– examen neurologique anormal des membres inf\u00e9rieurs
– r\u00e9duction du tonus anal<\/td><\/tr>
R\u00e9orientation<\/strong>
– Gold standard : IRM

Attention <\/strong>: comorbidit\u00e9s ou TTT m\u00e9dicaux peuvent mimer ces sympt\u00f4mes<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Visc\u00e8res<\/h3>\n\n\n\n
– Pathologies r\u00e9nales : n\u00e9phrolithiase, py\u00e9lon\u00e9phrite, abc\u00e8s p\u00e9rin\u00e9phrique
– Pathologies gastro-intestinales : pancr\u00e9atite, chol\u00e9cystite, ulc\u00e8re p\u00e9n\u00e9trant
– Pathologies des organes pelviens :  prostatite, endom\u00e9triose, maladies pelviennes inflammatoires chroniques (salpingite, endom\u00e9trite, ovarite\u2026)
– Pathologies vasculaires : an\u00e9vrisme aortique, dissection aortique, obstruction de la veine cave inf\u00e9rieure<\/td><\/tr><\/tbody><\/table><\/figure>\n","protected":false},"excerpt":{"rendered":"

Les lombaires Tumeur – Ant\u00e9c\u00e9dent de cancer– Perte de poids inexpliqu\u00e9e (5 \u00e0 10% en 3 \u00e0 6 mois)– Douleur nocturne \/ au repos \/ multi-site– Pas d\u2019am\u00e9lioration apr\u00e8s 4-6 semaines de traitement– Age >…<\/p>\n

Continue Reading \u00ab\u00a0Drapeaux rouges lombaires\u00a0\u00bb<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[464],"tags":[],"class_list":["post-7870","post","type-post","status-publish","format-standard","hentry","category-pathologies-des-lombaires"],"yoast_head":"\nDrapeaux rouges lombaires - wikine<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/kineaphp.fr\/?p=7870\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Drapeaux rouges lombaires - wikine\" \/>\n<meta property=\"og:description\" content=\"Les lombaires Tumeur – Ant\u00e9c\u00e9dent de cancer– Perte de poids inexpliqu\u00e9e (5 \u00e0 10% en 3 \u00e0 6 mois)– Douleur nocturne \/ au repos \/ multi-site– Pas d\u2019am\u00e9lioration apr\u00e8s 4-6 semaines de traitement– Age >…Continue Reading "Drapeaux rouges lombaires"\" \/>\n<meta property=\"og:url\" content=\"https:\/\/kineaphp.fr\/?p=7870\" \/>\n<meta property=\"og:site_name\" content=\"wikine\" \/>\n<meta property=\"article:published_time\" content=\"2026-01-04T07:46:55+00:00\" \/>\n<meta name=\"author\" content=\"kineaphp.fr\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"kineaphp.fr\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/kineaphp.fr\/?p=7870\",\"url\":\"https:\/\/kineaphp.fr\/?p=7870\",\"name\":\"Drapeaux rouges lombaires - 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