Differential Diagnosis for Thoracic Back Pain with Loss of Bowel and Bladder and Urinary Incontinence
- Single most likely diagnosis
- Spinal Cord Injury (SCI) or Spinal Cord Compression: This is the most likely diagnosis given the combination of thoracic back pain and loss of bowel and bladder function, which suggests a disruption in the spinal cord's ability to transmit signals.
- Other Likely diagnoses
- Thoracic Herniated Disk: A herniated disk in the thoracic spine can compress the spinal cord, leading to pain, loss of bowel and bladder function, and urinary incontinence.
- Spinal Stenosis: Narrowing of the spinal canal in the thoracic region can compress the spinal cord, resulting in similar symptoms.
- Cauda Equina Syndrome: Although more commonly associated with lumbar spine pathology, cauda equina syndrome can occur in the thoracic region and present with similar symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Spinal Epidural Abscess: A collection of pus in the epidural space surrounding the spinal cord can compress the cord and lead to severe neurological deficits, including loss of bowel and bladder function.
- Spinal Hematoma: Bleeding into the spinal canal can compress the spinal cord, resulting in rapid onset of neurological symptoms.
- Malignancy (e.g., spinal metastases): Cancer can metastasize to the spine, causing compression of the spinal cord and leading to neurological deficits.
- Rare diagnoses
- Transverse Myelitis: An inflammatory condition affecting the spinal cord, which can present with rapid onset of neurological symptoms, including loss of bowel and bladder function.
- Arteriovenous Malformation (AVM): An abnormal connection between blood vessels in the spine can lead to spinal cord compression and neurological deficits.
- Spondyloptosis: A rare condition where a vertebra slips out of place, potentially compressing the spinal cord and leading to neurological symptoms.