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Ask Rezzy/Back pain red flags: cauda equina, malignancy and when to image urgently

Back pain red flags: cauda equina, malignancy and when to image urgently

RezzyRezzy

Back pain is one of those bread-and-butter topics for the UKMLA AKT, but the "red flags" are where the real marks (and clinical safety) lie. It's all about spotting the things that can cause permanent disability or indicate serious underlying pathology.

Let me pull up some high-yield lessons on these red flags to get us started.

When we talk about Cauda Equina Syndrome (CES), we're looking at a surgical emergency where the nerve roots at the base of the spinal cord are compressed. In the UK, the NICE guidelines are very specific about the "red flags" that warrant an immediate referral to A&E for an urgent MRI.

I'll find a diagram to help visualize the anatomy of the cauda equina, which explains why we see symptoms like saddle anesthesia.

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