Radiology Corner Case #7
The latest Radiology Corner case is presented by Dr Thomas Bate, and investigates a patient with a history of cancer who has been experiencing worsening leg pain after a recent fall.
- A 59-year-old man presents complaining of worsening pain in his left leg. He has been experiencing weight loss and lower back pain for some months.
- He has a background history of Oesophageal cancer, Obstructive sleep apnoea, Hypercholesterolaemia, Idiopathic intracranial hypertension.
- He slipped in the shower one week ago and has been able to walk since then, but now the pain is significantly worse and he is unable to do a straight leg raise.
- You arrange an XRay of his pelvis which is shown below. Comment on the XRay.
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What are the treatment options for this condition?
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A month later………………….
- The patient developed worsening lower back pain, urinary retention and bilateral leg pain.
- An urgent MRI scan was arranged to rule out cauda equina syndrome.
- Comment on the images below.
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Further points for discussion
- What is cauda equina syndrome?
- How does this condition typically present?
- Can you think of some common causes?
- How is it managed?
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Further Reading
1.Metastatic Spinal Cord Compression (MSCC) and cauda equina syndrome
2. Metastatic spinal cord compression: diagnosis and management
BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2539 (Published 19 May 2016
3. Bone Metastasis – Current state of play: Translational Oncology
Volume 13, Issue 2, February 2020, Pages 308-320