![]() ![]() ![]() We identified those cases where the PVR was recorded. The reports were prepared for both claimants and defendants. We retrospectively reviewed the two senior authors’ 50 most recent medicolegal reports that concerned patients who were litigating in relation to CES. Whilst we value the assessment of objective measures to diagnose cauda equina syndrome and support the widespread use of bladder scanning, we wish to document our experience that cauda equina syndrome requiring emergency decompression can still be present when a PVR is less than 200 ml. in 1992 went even further and stated that “the predictive value of a negative test (no urinary retention) would be almost 0.9999”. have stated that if the PVR is ≤ 200 ml, and there are no clinical signs of CES, the probability of a negative MRI is 98.7%, and such patients do not require emergency MR imaging. The residual volume of urine present in the bladder post-void (PVR) has been proposed as an accurate assessment of the probability of a patient having CES. Bladder ultrasound is a cheap, noninvasive assessment of bladder function, which is widely available in emergency departments. This leads to high rates of negative MRIs in patients who have suspected CES. Many symptoms and signs are quoted as “red flags” for CES but none reliably predict cauda equina (CE) compression on MR imaging. There is no universally agreed definition of CES. The failure to diagnose and treat CES before there is permanent and/or severe neurological injury is important for all patients and is also important medicolegally. ![]() Early diagnosis and treatment of CES can prevent harm. The CES is a condition that can lead to severe disabling symptoms causing long-term social and medical morbidity. ![]()
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