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Metastatic spinal cord compression — SCE Acute Medicine MCQ

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HardAcute Neurological PresentationsMetastatic spinal cord compressionSCE Acute Medicine

A patient with metastatic prostate cancer develops a thoracic sensory level, bilateral weakness and urinary hesitancy. What is the required imaging timetable?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Arrange urgent whole-spine MRI within twenty-four hours

The best answer is “Arrange urgent whole-spine MRI within twenty-four hours”. This is correct because neurological signs with known cancer indicate suspected metastatic spinal cord compression. Whole-spine imaging detects multiple levels and must not be delayed while deficit progresses. Plain radiography, limited lumbar CT, outpatient timing and waiting for later cauda-equina signs risk irreversible disability.

Reference: NICE NG234 spinal metastases and metastatic cord-compression recommendations: https://www.nice.org.uk/guidance/ng234/chapter/Recommendations