Investigations
Investigations to consider
MRI spine
Test
Recommended if there are any new acute neurological or functional changes.[43]
Perform as needed.
Result
vertebral body or spinal cord lesions
EMG
Test
Can be used if a focal compression neuropathy is suspected.
Can help differentiate symptoms with a peripheral source from those with a central source such as the cord.
Perform as needed.
Result
aetiology and localisation of neuromuscular pathology
urodynamic studies
Test
Required for proper assessment of co-ordinated urinary bladder and sphincter function.[46]
Follow-up studies can be used to monitor the evolution of the dysfunction and detect response to medicines.[44]
Perform as needed.
Result
urinary bladder and sphincter function; bladder pressures; bladder capacity and compliance; bladder spasticity
bladder ultrasound
renal ultrasound
Test
Used in conjunction with a bladder ultrasound to assess the health of the urinary system.
Perform annually with a bladder ultrasound.[45]
Result
identifies renal stones, hydronephrosis, pyelonephritis, and scarring
micturition cysto-urethrogram
Test
A dynamic and invasive assessment of the flow mechanism.
Used to visualise bladder hypertrophy and other pathology.
Perform as needed.
Result
incomplete bladder emptying; obstruction; bladder reflux to the kidney; bladder hypertrophy
bone densitometry (DEXA)
laboratory evaluation
Test
Should be checked annually as part of health maintenance screening: full blood count; comprehensive metabolic panel with magnesium, calcium, and phosphorus; liver function panel; lipid panel; haemoglobin A1c; 25-hydroxy vitamin D level.
Consider metabolic bone markers (e.g., C-telopeptide, osteocalcin, procollagen type 1 N propeptide) in conjunction with endocrine specialty to assess bone turnover.
Result
changes in health, organ system, cardiovascular disease risk factors, bone metabolism
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