Step 2

Neurology 11

A 72-year-old man visits the doctor due to complaints of severe low back pain for the past week as well as urinary and fecal incontinence for the last two days. He is currently receiving chemotherapy for transitional cell carcinoma of the bladder. Vital signs are within normal limits. On physical examination, there is tenderness over the lumbar spine at L4-L5 and reduced sensation below this level with numbness in his legs. A rectal examination shows a decreased sphincter tone, and his prostate is generally enlarged.

Which of the following is the most appropriate next step in diagnosis?

  • A) Cystourethrography
  • B) Magnetic resonance imaging (MRI) of the spine
  • C) Measurement of serum prostate-specific antigen (PSA)
  • D) Renal ultrasonography
  • E) Urine culture


Lloyd Taylor


Dr. Ted O'Connell

Last updated

Jun 09, 2024

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