A 57-year-old man
one month history of worsening low back pain
radiates down the back of both legs and suddenly increased yesterday.
For the past 2 days, have difficulty voiding
skin around his anus feels numb when he wipes with toilet tissue.
He denies prior trauma to or surgery on his back.
- Most likely diagnosis: Cauda equine syndrome
Aetiology Central disk herniation multiple, involving bilateral nerve roots
the next diagnostic step MRI
Why Cauda Equina and not other causes of LBP because cardinal signs of Cauda equina syndrome are
, urinary retention and overflow incontinence, decreased rectal tone, saddle anesthesia
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