Bladder ultrasonography in the assessment of cauda equina syndrome in the emergency department: a literature review

For cauda equina syndrome (CES), current clinical assessment in the emergency department usually involves perianal sensation (PAS) and anal tone (AT). Neither reliably predict magnetic resonance imaging (MRI) demonstrating a large central disc prolapse (MRI+). Other clinical examination findings inc...

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Bibliographic Details
Published in:Annals of the Royal College of Surgeons of England 2024-01, Vol.106 (1), p.9-12
Main Author: Todd, N V
Format: Article
Language:English
Subjects:
Back pain
Bladder
Cauda Equina Syndrome
Cauda Equina Syndrome - diagnostic imaging
Emergency medical care
Emergency Service, Hospital
Fecal incontinence
Humans
Intervertebral Disc Displacement
Magnetic resonance imaging
Patients
Polyradiculopathy - diagnostic imaging
Surgery
Ultrasonic imaging
Urinary Bladder - diagnostic imaging
Urinary incontinence
Urinary retention
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Summary:For cauda equina syndrome (CES), current clinical assessment in the emergency department usually involves perianal sensation (PAS) and anal tone (AT). Neither reliably predict magnetic resonance imaging (MRI) demonstrating a large central disc prolapse (MRI+). Other clinical examination findings increase the probability of MRI+. Other tests of sacral nerve root function include anal squeeze (AS) and the bulbocavernosus reflex (BCR). If BCR, PAS and AT, and AS are combined and they are all normal, CES can be excluded in almost all cases. Portable bladder ultrasonography is now commonly used to assess bladder function, particularly in measuring the post-void residual urinary volume (PVR). PVR is deemed normal at
ISSN:0035-8843
1478-7083
DOI:10.1308/rcsann.2022.0168