Cauda equina syndrome: The Daily PANCE Blueprint

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Cauda equina syndrome: The Daily PANCE Blueprint

A 70-year-old male presents to the emergency with acute onset of lower back pain. He also has bowel dysfunction and loss of sensation over his inner thighs. Physical exam is remarkable for decreased lower extremity reflexes. What is the most likely diagnosis?

A. Muscle spasm
B. HIV-related myelopathy
C. Cauda equina syndrome
D. Conus medullaris syndrome
E. Transverse myelitis

Answer and topic summary

The answer is C. Cauda equina syndrome

Cauda equina syndrome is a surgical emergency caused by severe stenosis in the lumbar spine (often due to acute disc herniation). Clinical manifestations include bowel/bladder dysfunction, decreased lower extremity reflexes, sciatica, saddle anesthesia loss of sensation over the perineum, buttock, and medial aspect of thighs), and decreased anal sphincter tone. Symptoms can develop acutely or chronically. An emergent MRI of the lumbosacral spine is the preferred diagnostic test. Surgery is the preferred treatment.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ Spinal Disorders ⇒ Cauda equina syndrome

Also covered as part of the Emergency Medicine PAEA EOR topic list

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