A 52-year-old man arrives with severe low back pain and new urinary retention. Triage acuity is ESI 2; BP 142/80 mm Hg, HR 98/min. He has bilateral

Question

A 52-year-old man arrives with severe low back pain and new urinary retention. Triage acuity is ESI 2; BP 142/80 mm Hg, HR 98/min. He has bilateral sciatica, saddle anesthesia, and decreased anal tone. Strength is 4/5 in both ankles. Which of the following is the most appropriate imaging study?

Accepted Answer

MRI lumbar spine without and with contrast as clinically appropriate

Answer

Abdominal ultrasound

Answer

CT head without contrast

Answer

No imaging before outpatient follow-up

Answer

Plain lumbar radiographs

Cauda equina syndrome — ABEM Board MCQ

A 52-year-old man arrives with severe low back pain and new urinary retention. Triage acuity is ESI 2; BP 142/80 mm Hg, HR 98/min. He has bilateral sciatica, saddle anesthesia, and decreased anal tone. Strength is 4/5 in both ankles. Which of the following is the most appropriate imaging study?