A clinical diagnosis of cauda equina syndrome can be achieved with thorough history-taking, a physical examination and radiologic studies.
Diagnosing cauda equina syndrome
Although cauda equina syndrome is rare, it should be possible for any reasonably competent medical practitioner to diagnose the condition. This can be achieved in the following way:-
1. History-taking
When a patient seeks medical attention for the symptoms of cauda equina syndrome, a medical practitioner should recognise them as being indicative of compressed spinal nerves. An interview should then take place, during which the doctor must establish the exact nature of the symptoms and the chronological order in which they occurred. Questions should also be raised as to whether there has been a history of trauma, as this is the cause of CES in around 62% of patients.
2. A physical examination
If this history-taking corresponds with the possibility of cauda equina syndrome, a medical practitioner should then proceed with a physical examination. During this examination a doctor should look for decreased reflexes in the lower limbs, poor anal tone and reduced sensation in the perineal area. Other differential diagnoses should also be investigated during this examination.
3. Imaging tests
If there is any suspicion that a patient has cauda equina syndrome, he/she should be urgently referred for radiologic studies. The diagnostic tool of choice is an MRI scan. However, some patients will be unable to have an MRI scan – for example, those with pacemakers or aneurysm clips. Where an MRI is contraindicated a CT scan should be carried out. With the help of imaging tests, medical professionals should be able to confirm spinal nerve compression, and in most cases identify the cause of compression.
Delay in diagnosing cauda equina syndrome
Unfortunately there are times when medical practitioners do not take the aforementioned steps, and therefore do not achieve a timely diagnosis. Often this is because they fail to note the full history of a patient’s symptoms, leading them to make a misdiagnosis. However, it is usually the case that this could have been avoided, had thorough history-taking and a physical examination taken place.
If you are one such patient to suffer a delayed diagnosis of cauda equina syndrome, you need to consider the consequences of this delay. If it has caused you additional complications which could have been avoided with an earlier diagnosis, you will be considered the victim of substandard medical care. This means you will be entitled to claim compensation for the damage wrongfully incurred. Contact us today to find out more.