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Group test

Clinical problem

History
Y.A 60yrs, complains of backache which is
progressi e !aw G". #ol$ to change matress !elf%referre$ to C& '. "ain is worse with lying $own. (ist ) $ifferential $iagnoses

*+amination
(ooke$ worrie$, not waste$, pale,
afebrile. #here was lumbosacral ten$erness an$ !(& was positi e at ,00. H- $ispatche$ YA to ra$iology for plain .%rays of the (! spine. He was accompanie$ by his relati es an$ a HCA. He was a$mitte$ to /0 without a $iagnosis.

#he &esi$ent who re iewe$ thought YA

coul$ ha e a spinal cor$ tumor. *+amination re eale$ a complete flacci$ paralysis of the legs. 1hat shoul$ ha e been $one before sen$ing YA for .%ray of the (! spine2 1hat has happene$ to YA2 (ist 6 causes of flacci$ paralysis.

#he consultant foun$ that there was loss of all

sensory 3ualities with loss of oluntary control of the rectum. YA re3ueste$ for $ischarge on the '4th $ay of a$mission for herbal treatment. He was re%a$mitte$ 5 months later complaining stiff legs. #he consultant 3uickly e+amine$ an$ conclu$e$ that YA ha$ spinal cor$ compression /escribe the possible physical fin$ings. .

6ame 4 tumors likely to cause cor$


compression

1hich stu$ies shoul$ be or$ere$ to


confirm YA,s $iagnosis2 i

7t is confirme$ that YA has a spinal

cor$ tumor with compression of the cor$. 1hat are the treatment options for YA2