The Evaluation of Digital Rectal Examination for Assessment of Anal Tone in Suspected Cauda Equina Syndrome

Sherlock, Katrina Eve; Turner, William; Elsayed, Sherief; Bagouri, M.; Baha, L.; Boszczyk, Bronek M.; McNally, Donal

doi:10.1097/brs.0000000000000902

Cited by 21 publications

(5 citation statements)

References 27 publications

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“… 11 In a model simulating AT, only 64% of AT assessments were correct. 12 PAS and AT are not the most sensitive signs of sacral nerve root injury. The assessment of anal squeeze (AS) may be more accurate than AT.…”

Section: Letter To the Editormentioning

confidence: 90%

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Clinical Examination and the Diagnosis of Cauda Equina Syndrome. More Examination, Not Less

Todd

2022

Global Spine Journal

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Section: Letter To the Editormentioning

confidence: 90%

“…The assessment of anal squeeze (AS) may be more accurate than AT. 12 The bulbocavernosus reflex (BCR) is rarely tested in CES, but an absent BCR has a high correlation with MRI+. 1 Even though a single sign has a poor correlation with MRI+, combinations of signs are more accurate.…”

Section: Letter To the Editormentioning

confidence: 99%

Clinical Examination and the Diagnosis of Cauda Equina Syndrome. More Examination, Not Less

Todd

2022

Global Spine Journal

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“…However, DRE performs poorly compared with objective measures of anal tone in both simulation [27] and clinical studies [28]. Reduced anal squeeze has also been proposed as a late sign [29], which would limit its value for early detection of CES.…”

Section: Physical Examinationmentioning

confidence: 99%

Diagnosis of cauda equina syndrome in the emergency department

Metcalfe,

Hoeritzauer,

Angus

et al. 2023

Emerg Med J

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Cauda equina syndrome (CES) is a spinal emergency that can be challenging to identify from among the many patients presenting to EDs with low back and/or radicular leg pain. This article presents a practical guide to the assessment and early management of patients with suspected CES as well as an up-to-date review of the most important studies in this area that should inform clinical practice in the ED.

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“…Reduced anal tone was recorded in 23 (22%) of the 106 patients with CES in the three studies,347 and normal anal tone was recorded in 35 (33%) of those with CES. Other studies of anal tone assessments in clinical circumstances and using model simulations have shown poor levels of sensitivity, specificity, and internal agreement 1213…”

Section: How Is It Diagnosed?mentioning

confidence: 99%