In Session 032201-3 we’re joined by Mark Cheel from Geelong, Australia. Mark works in an emergency department triaging patients to the appropriate care pathway as well as teaching MDT for the Mckenzie Insitute Australia. Mark shares a series of three cases this month. The second, highlighted here, is a 35 yr old female with a leg pain worse with standing, walking and abnormalities with bladder retention and confirmed disc extrusion. Through a thorough power point presentation, Mark touches on how he further questions and tests for cauda equina symptoms for the patient's safety, her physical exam findings and initial response to repeated movements. Specific myotomal weakness testing advice is given by Mark as well and some patterns Mark has seen with similar patients and how he tends not to progress the forces as aggressively. He explains what led this patient to consider microdiscectomy, and his focus on initial post-surgical appointments. Mark supports his comments and management of this patient with a few studies related to this clinical presentation. This case offers high level clinical differential diagnosis and bits on management and education for challenging radiculopathy patients by this veteran expert.

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