A 48-year-old man with chronic low back pain presents with new bilateral sciatica, saddle anaesthesia and difficulty initiating urination over 24 hour...

Question

A 48-year-old man with chronic low back pain presents with new bilateral sciatica, saddle anaesthesia and difficulty initiating urination over 24 hours. Lower limb power is reduced with decreased ankle reflexes. What is the most appropriate next step?

Accepted Answer

Arrange urgent MRI of the lumbar spine and neurosurgical consultation

Answer

Prescribe stronger analgesia and review in 2 weeks

Answer

Refer for routine physiotherapy

Answer

Order lumbar spine X-rays only

Answer

Start oral steroids and observe for improvement

uk-plab-1 MCQ (SBA): Cauda equina syndrome

A 48-year-old man with chronic low back pain presents with new bilateral sciatica, saddle anaesthesia and difficulty initiating urination over 24 hours. Lower limb power is reduced with decreased ankle reflexes. What is the most appropriate next step?