Marion presents to your office with back pain associated with constipation and urinary retention. Which of the following is most likely?
A) Sciatica
B) Epidural abscess
C) Cauda equina
D) Idiopathic low back pain
C) Cauda equina
The presence of bowel and bladder symptoms associated with back pain is worrisome and should suggest impingement of nerve roots S2–S4. For this reason idiopathic low back pain is unlikely. Epidural abscess may present with midline pain which can be increased with percussion over the spinous processes. Sciatica is associated with pain which radiates into the buttocks and/or down the posterior leg in the S1 distribution.
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