5 Steps of Diagnosing Cauda Equina Syndrome

There are five major steps that must be taken if cauda equina syndrome is to be accurately diagnosed in a timely manner. This is extremely important as the condition must be treated quickly if permanent disability is to be avoided.

Diagnosing cauda equina syndrome

1. Establishing a patient’s symptoms

Whenever a patient presents to their GP or A&E, the attending medical practitioner must establish a patient’s symptoms in their entirety, as this is the first step towards a diagnosis. Where cauda equina syndrome is concerned, a patient will most likely be complaining of:

• Back pain radiating to one or both legs
• Loss of sensation in the genital area, around the buttocks and perineum (the saddle area)
• Dribbling urinary incontinence or other urinary dysfunction
• Bowel problems, manifesting as either incontinence or constipation

When a medical practitioner hears these symptoms, cauda equina syndrome should immediately be on their list of potential diagnoses. It is especially important to note whether the ‘red flag’ symptoms are present. These include urinary dysfunction, loss of sensation in the saddle area and lower back pain.

2. Taking a detailed history

Next a medical practitioner should take a detailed history of these symptoms, establishing when they appeared and whether there has been any deterioration in their severity. This may help to confirm what caused a patient’s condition – for example, a traumatic accident that has resulted in a slipped disc.

3. Examination

When a patient is display the symptoms of cauda equina syndrome, it should prompt medical practitioners to carry out a thorough neurological examination. This will reveal:

• Reduced anal tone
• Sensory loss involving S2/3/4 dermatomes
• Sensory loss in the saddle area – i.e. the perineum and buttocks
• Sciatic-type pain
• Positive straight leg raise test
• Poor reflexes in the lower extremities
• Foot drop

4. Other tests

In addition to a full neurological examination, blood and urine tests should also be carried out to exclude other possible conditions. Ordinarily the test results will be normal (unless cauda equina syndrome has been caused by an infection).

5. MRI scan

Any reasonably competent medical practitioner will consider the patient’s history, their symptoms and their examination/test results and suspect a clinical diagnosis of cauda equina syndrome. This can be confirmed with a MRI scan. A reasonably competent medical practitioner will know that cauda equina syndrome is a medical emergency, meaning an MRI scan must be performed upon an emergency basis.

Missed diagnosis

If medical practitioners fail to provide a reasonably competent level of medical care, resulting in a missed diagnosis, there will be grounds for a cauda equina claim. Contact us today to find out more.

Please call us free on 0800 234 3300, from a mobile click to call 01275 334030 or complete our Free Online Enquiry for a no cost, no obligation opinion.

Share Article With: