Question

A 48-year-old man presents with severe low back pain radiating to both legs, saddle anaesthesia, and difficulty passing urine. Examination reveals decreased anal tone. What is the most appropriate next step?

Accepted Answer

Urgent MRI of the spine and neurosurgical referral

Answer

Prescribe NSAIDs and physiotherapy

Answer

Arrange non-urgent lumbar spine X-ray

Answer

Start oral steroids and review in 1 week

Answer

Refer to community musculoskeletal clinic

Practice question

A 48-year-old man presents with severe low back pain radiating to both legs, saddle anaesthesia, and difficulty passing urine. Examination reveals decreased anal tone. What is the most appropriate next step?