Question

A 28-year-old man presents with sudden onset severe low back pain, urinary retention and numbness in the perineal area. Examination reveals decreased anal tone and bilateral leg weakness. What is the most appropriate next step?

Accepted Answer

Order urgent MRI of the lumbosacral spine and urgent neurosurgical referral

Answer

Start NSAIDs and review in 1 week

Answer

Arrange routine physiotherapy referral

Answer

Order lumbar spine X-ray only

Answer

Refer to pain clinic

Practice question

A 28-year-old man presents with sudden onset severe low back pain, urinary retention and numbness in the perineal area. Examination reveals decreased anal tone and bilateral leg weakness. What is the most appropriate next step?