A 40-year-old has low back pain with new urinary retention and saddle numbness. What is the right action?
Answer and explanation
Correct answer: A. Same-day emergency assessment with MRI for suspected cauda equina syndrome
- Step 1: These are red flags for cauda equina syndrome.
- Step 2: Delay in decompression leads to permanent bladder, bowel and sexual dysfunction.
Answer
Same-day emergency assessment with MRI for suspected cauda equina syndrome.
Why not the others: Prescribe naproxen 500 mg twice daily and review in four weeks with an exercise leaflet: Analgesia alone misses an emergency. Advise bed rest for a week with codeine and a fit note for the same period: Bed rest does not treat compression. Refer to routine NHS physiotherapy with an appointment expected within three months: Physiotherapy is inappropriate.
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