Differential Diagnosis for Radiculopathy with Urinary Difficulty

Single Most Likely Diagnosis

• Lumbar Disc Herniation with Cauda Equina Syndrome: This condition is the most likely diagnosis given the progression of radiculopathy from the thigh to the ankle, accompanied by difficulty urinating. The cauda equina syndrome is a serious condition that occurs when the nerves in the spinal canal are compressed, leading to neurological symptoms such as numbness, weakness, and bladder or bowel dysfunction.

Other Likely Diagnoses

• Lumbar Spinal Stenosis: This condition involves narrowing of the spinal canal, which can compress the spinal cord or nerves, leading to radiculopathy and potentially affecting bladder control.
• Spondylolisthesis: A condition where a vertebra slips out of place, potentially compressing nerves and leading to radiculopathy and urinary symptoms.
• Spinal Tumor: Tumors in the spine can compress nerves, leading to radiculopathy and other neurological symptoms, including urinary difficulties.

Do Not Miss Diagnoses

• Spinal Epidural Abscess: A serious infection that can compress the spinal cord or nerves, leading to rapid neurological deterioration, including radiculopathy and loss of bladder control. Early diagnosis and treatment are crucial to prevent permanent damage.
• Spinal Hematoma: Bleeding in the spinal canal can compress the spinal cord or nerves, leading to acute neurological symptoms. Prompt recognition and intervention are necessary to avoid long-term consequences.

Rare Diagnoses

• Arachnoiditis: Inflammation of the arachnoid membrane surrounding the spinal cord, which can cause nerve root symptoms and potentially affect bladder function. It is a rare condition but should be considered in the differential diagnosis of progressive radiculopathy with urinary symptoms.
• Neurosyphilis: A rare condition that can cause a variety of neurological symptoms, including radiculopathy and bladder dysfunction, due to syphilis infection affecting the nervous system.