Case challenge · Oncology / Neurology / Orthopedics · teaching

Metastatic Spinal Cord Compression (MSCC) — Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

← View the full flowchartBased on NICE NG234

Case #1Oncology / Neurology / Orthopedics

📋 Case data

Suspected MSCC?Back pain only, no neurological symptoms

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · Suspected MSCC?

Cancer patient with back pain + neurological symptoms — suspected MSCC?

💡 Oncological emergency (current or past cancer; ~20% as the first presentation; breast/prostate/lung/myeloma, thoracic spine most common). Red flags: severe back/band-like thoracic/radicular pain, worse on coughing/straining/lying flat, night pain + new limb weakness/sensory level/gait disturbance/bladder-bowel dysfunction (late). Do not wait for paralysis.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.