Diff Diag

So, seeing a lady in her 60's with back and leg pain who can barely walk and has a positive Babinski bilaterally and a serious Marie Fioux bilaterally. When sitting or lying she will involunarily flex up one LE, especially if stretching. It started 2 years ago and she saw a neurologist recently that said she was FINE! My CI called her PCP who just wanted to refer her back to the same neurologist. Thankfully, the patient insisted on an MRI which she should get this week or next. Kinda scared to hear what they find.

Then, seeing a sweet little lady with M.S. post laminectomy who told me on Tues that she finally got her bladder back that morning....didn't know it wasn't there to begin with but yay! Then on Thursday when we see her she says she has bad back pain and "numbness in her seat, inside and out." So, being the curious george I am , when I was stretching her I asked how well her baldder was doing since Tuesday...we've bonded...and she says not as well. Then I ask her about her numbness again and she describes it as being in the area a saddle would be. And to top it off, she's never had this problem before. Mention it to my CI who basically says lets wait to see if it is consistent for a few days. I'm like, is this a Red Flag call the docotor moment or a Red Flag rush to the ER moment, or a yellow flag let's wait and watch it moment??!

Reminder, I'm in an outpatient clinic. Differential Diag is haunting me.

Paslay