Spine: cauda equina syndrome: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Spine: cauda equina syndrome

Sample item

A patient with low back pain develops bilateral sciatica, saddle anesthesia, and urinary retention. What is the appropriate next investigation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Urgent MRI of the lumbosacral spine

Cauda equina syndrome is a time-critical neurologic emergency requiring urgent MRI to identify compressive pathology and prompt surgical review. Delayed decompression can result in permanent bladder and neurologic dysfunction.

Option by option

  • A. Urgent MRI of the lumbosacral spine (correct)

    Correct. MRI rapidly evaluates the cauda equina and compressive lesions.

  • B. DEXA scan

    DEXA measures bone density rather than acute neural compromise.

  • C. Routine lumbar radiograph in six weeks

    Plain radiographs do not evaluate neural compression and delay care.

  • D. Ultrasound of the shoulder

    Shoulder ultrasound is unrelated.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Urgent MRI of the lumbosacral spine. Cauda equina syndrome is a time-critical neurologic emergency requiring urgent MRI to identify compressive pathology and prompt surgical review.

Why is "DEXA scan" not the answer?

DEXA measures bone density rather than acute neural compromise.

Why is "Routine lumbar radiograph in six weeks" not the answer?

Plain radiographs do not evaluate neural compression and delay care.

Why is "Ultrasound of the shoulder" not the answer?

Shoulder ultrasound is unrelated.

What concept does this question test?

It tests Spine: cauda equina syndrome in Orthopaedics. Delayed decompression can result in permanent bladder and neurologic dysfunction.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Spine: cauda equina syndrome?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.