Question

A 43-year-old man presents with low back pain radiating to both legs, urinary retention and saddle anaesthesia. Examination reveals reduced anal tone. What is the most appropriate next step?

Accepted Answer

Urgent MRI of the lumbosacral spine and neurosurgical referral

Answer

Reassure and prescribe simple analgesia

Answer

Arrange outpatient physiotherapy referral

Answer

Order lumbar spine X-ray and review in 2 weeks

Answer

Start long-term opioids in primary care

Practice question

A 43-year-old man presents with low back pain radiating to both legs, urinary retention and saddle anaesthesia. Examination reveals reduced anal tone. What is the most appropriate next step?