A 29 year old man presents with acute onset severe low back pain radiating to both legs, difficulty passing urine and numbness in the perianal area. H...

Question

A 29 year old man presents with acute onset severe low back pain radiating to both legs, difficulty passing urine and numbness in the perianal area. He has reduced anal tone on examination. What is the most appropriate next step in management?

Accepted Answer

Arrange urgent lumbar spine MRI and neurosurgical review

Answer

Start non steroidal anti inflammatories and review in 2 weeks

Answer

Refer to physiotherapy as an outpatient

Answer

Request lumbar spine X ray and treat as muscular back pain

Answer

Prescribe Amitriptyline for neuropathic pain and discharge

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

A 29 year old man presents with acute onset severe low back pain radiating to both legs, difficulty passing urine and numbness in the perianal area. He has reduced anal tone on examination. What is the most appropriate next step in management?