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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Monday, October 18, 2021

Cauda Equina

St Emlyn's
St Emlyn’s - By Simon Carley - October 17, 2021
“The bottom line.
Patients with atraumatic back pain who are clinically suspected to have cauda equina syndrome following thorough assessment,should undergo MR imaging to evaluate for evidence of radiological compression. Clinicians should not solely rely on the presence or absence of specific clinical symptoms or signs to rule in or rule out CES. 
A key message is that the absence of perineal signs should not be used as a reason to not perform an MR scan.
In addition, these findings suggest EM clinicians should carefully consider how a digital rectal examination on patients with suspected CES will influence clinical decision making. This information should also be discussed with patients, to allow informed consent. In the cohort presented, this invasive aspect of routine assessment appeared to add no additional diagnostic value. If these findings can be replicated and validated through prospective research, routine invasive DRE could potentially be avoided without impact on diagnosis”