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Spinal epidural abscess — ABEM Board MCQ

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HardNeurological emergenciesSpinal epidural abscessABEM Board

A 58-year-old man arrives as ESI 2 with severe back pain and fever. He uses injection drugs. BP 102/64, HR 116, WBC 18,000/mcL, ESR is elevated, and he has new urinary retention with leg weakness. Which of the following is the most appropriate imaging study?

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

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Correct answer: D — MRI spine with contrast

Fever, injection drug use, back pain, neurologic deficit, and urinary retention suggest spinal epidural abscess; MRI with contrast is preferred.

Reference: IDSA vertebral osteomyelitis guidance; ACEP neurologic emergency resources