Can digital rectal examination be used to detect cauda equina compression in people presenting with acute cauda equina syndrome? A systematic review and meta-analysis of diagnostic test accuracy studies
Digital rectal examination of anal tone is no longer recommended in the assessment of suspected cauda equina compression.
They found that DRE of anal tone is potentially harmful due to its low sensitivity and high risk of false reassurance.
Doing the test increases the chances of missing a case of cauda equina compression, with potentially devastating consequences for the patient and an increased risk of litigation for the clinician.
The team therefore recommend that DRE of anal tone for CES assessment should no longer be used in any clinical setting.
The diagnostic accuracy of DRE of anal sensation, squeeze and reflexes was also low, but the research on these other sub-tests was very limited and more research is needed to make meaningful recommendations.
Please email julia.tabrah1@nhs.net if you have any questions or comments.