Misdiagnosed hamstring strain injury: a case report of early cauda equina syndrome.

Objective: This case report discusses the diagnostic challenges associated with the early identification of cauda equina syndrome in a 25-year-old patient without lumbar spinal pain. It introduces a new classification scheme related to a more effective diagnosis.

Clinical features: The patient experienced pain in the right hamstring, diagnosed as a pulled muscle. Later, he experienced new symptoms of testicular pain and bladder issues.

Intervention and outcomes: Chiropractic treatments alleviated his right hamstring pain, albeit temporarily. Subsequently, new symptoms emerged, prompting the patient's referral to a local hospital. An MRI examination revealed a large lumbar disc herniation, leading to a microdiscectomy.

Summary: The reader will learn about a new classification of five different levels of CES. This classification is an important tool in clinical practice. This article also reviews critical information about the mixed neurological presentations of cauda equina syndrome, helping practitioners better understand these important clinical variants.