A 45-year-old man presents with low back pain radiating down the left leg and numbness in the perineal area. He reports difficulty initiating urinatio...

Question

A 45-year-old man presents with low back pain radiating down the left leg and numbness in the perineal area. He reports difficulty initiating urination and recent faecal incontinence. Examination reveals reduced anal tone and bilateral leg weakness. What is the most appropriate action?

Accepted Answer

Urgent MRI spine and immediate neurosurgical referral

Answer

Prescribe NSAIDs and arrange physiotherapy

Answer

Order an outpatient lumbar spine X-ray

Answer

Advise rest and review in 2 weeks

Answer

Start Gabapentin and review in 6 weeks

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

A 45-year-old man presents with low back pain radiating down the left leg and numbness in the perineal area. He reports difficulty initiating urination and recent faecal incontinence. Examination reveals reduced anal tone and bilateral leg weakness. What is the most appropriate action?