Case 3

A 63-year-old man walks into the ED and complains that he had chronic back pain for many years and this has been more severe over the past five days, radiating into both legs. He is taking large doses of paracetamol, codeine and diclofenac and he presents with constipation. He has no urinary symptoms.

What should you decide to do?

Following the full neurological examination of the lower limbs what would you do next?

If the MRI shows any evidence of a central disk prolapse (image, below) compressing the spinal cord, or cauda equina, what would you do next?

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