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Metastatic spinal cord compression — RCPSC EM MCQ

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HardNeurological emergenciesMetastatic spinal cord compressionRCPSC EM

A 50-year-old man with cancer presents with new severe thoracic back pain, bilateral leg weakness and urinary hesitancy. Temperature is normal. Examination shows a sensory level at T8 and brisk reflexes. What is the most appropriate investigation?

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

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Correct answer: C — Urgent MRI of the whole spine

Cancer plus back pain with myelopathic signs suggests metastatic spinal cord compression; urgent MRI is the diagnostic test.

Reference: Royal College Emergency Medicine exam format and training experiences