Differential Diagnosis for Low Back Pain with Constipation and Urinary Retention
- Single most likely diagnosis
- Cauda equina syndrome: This condition is characterized by low back pain, bowel and bladder dysfunction (such as constipation and urinary retention), and potentially sensory or motor deficits in the lower limbs. The combination of symptoms presented matches closely with cauda equina syndrome, making it the most likely diagnosis.
- Other Likely diagnoses
- Epidural abscess: Although less common, an epidural abscess can cause low back pain, neurological deficits, and potentially affect bowel and bladder function due to spinal cord compression. The presence of constipation and urinary retention could be indicative of spinal cord involvement.
- Sciatica: While sciatica typically presents with radiating pain down the leg, severe cases could potentially lead to neurological deficits affecting bladder and bowel function. However, this would be less common and typically accompanied by significant pain radiating down the leg.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Spinal cord compression or injury: Conditions such as spinal tumors, traumatic injuries, or other space-occupying lesions can compress the spinal cord, leading to the symptoms described. Early diagnosis and intervention are critical to prevent permanent neurological damage.
- Infectious processes (e.g., discitis, osteomyelitis): Infections of the spine can cause severe back pain and, if they compress or involve the spinal cord, can lead to neurological deficits including bowel and bladder dysfunction.
- Rare diagnoses
- Idiopathic low back pain with referred symptoms: While idiopathic low back pain is common, it rarely presents with significant bowel and bladder dysfunction without other underlying causes. This diagnosis would be considered only after ruling out more serious conditions.
- Other neurological conditions (e.g., multiple sclerosis, spinal stenosis): These conditions can cause a variety of neurological symptoms, including bowel and bladder dysfunction. However, they would typically be accompanied by other symptoms and signs not mentioned in the scenario.