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Cauda equina syndrome — ACEM Fellowship MCQ

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ModerateNeurological emergenciesCauda equina syndromeACEM Fellowship

A 45-year-old warehouse worker presents to a regional ED, triage category 2, with acute back pain, urinary retention and saddle numbness. He has bilateral sciatica and reduced anal tone. Temperature is 36.9 C and CRP is normal. What is the most appropriate investigation?

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

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Correct answer: A — Urgent MRI lumbosacral spine

Urinary retention, saddle anaesthesia and reduced anal tone require urgent MRI and spinal surgical discussion.

Reference: ACEM neurology curriculum; spinal emergency guidance