Trauma
An initial plain film would be appropriate 
if there is a history of recent significant trauma, or even a history of minor trauma in an elderly patient.

Red Flags > MRI
Immediate MRI is appropriate in the presence of red flags such as bladder dysfunction, 
areflexia, saddle anesthesia, progressive motor weakness, a history of cancer, or the presence of fever, unexplained weight loss, or night sweats.

Reference

ACR recommendations.

Physician 2009;79(12):1067-1074.

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