QuestionSBA
QuestionChoice
This is incorrect. The gold standard investigation for cauda equina syndrome is a whole spine MRI.
10027638
c
Order an x-ray spine
QuestionChoice
This is incorrect. This patient presents with symptoms concerning for cauda equina syndrome. The gold standard investigation for cauda equina syndrome is a whole spine MRI.
10027640
e
Insert a urinary catheter
QuestionChoice
This is incorrect. It is important to confirm and find the cause of the patient's cauda equina before considering surgery.
10027639
d
Lumbar decompression surgery
QuestionChoice
This is incorrect. The gold standard investigation for cauda equina syndrome is a whole spine MRI.
10027637
b
Order a CT spine
QuestionChoice
This is the correct answer. Whole spine MRI is the gold standard test for suspected cauda equina syndrome. This will identify the cause and location of the cord compression. The patient has a past medical history of prostate cancer and therefore the cause of their cauda equina is likely to be spinal metastasis.
10027636
a
Order a whole spine MRI
Concept
Chapter
2693
3772
Cauda equina syndrome
Topic
145
Orthopaedics
17925
An 81 year old male presents to the A&E department due to back pain. He reports shooting pains in his buttocks radiating down both legs for 5 days. He became particularly concerned earlier that day whilst using the toilet; he noticed he was unable to feel the toilet paper when wiping.

The patient has a past medical history of prostate cancer, but is not currently receiving chemotherapy.

Which of the following is the best next step in the management of this patient?
a