Examination must be thorough

doi:10.1136/bmj.b1724

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Angelos G Kolias, core surgical trainee1,
Saurabh Odak, registrar in trauma and orthopaedics2,
Atul K Tyagi, consultant neurosurgeon3

¹Ipswich Hospital, Ipswich IP4 5PD
²Darlington Memorial Hospital, Darlington DL3 6HX
³Leeds General Infirmary, Leeds LS1 3EX

angeloskolias{at}gmail.com

As well as neurological examination of the legs, perianal and perineal sensation should be assessed in cases of suspected cauda equina syndrome.1 This may prove challenging in primary care settings, but it is the safest way of appropriately triaging such patients, facilitates referral, and provides …