Imagine you're in the ED, and a previously mobile 55-year-old male arrives with sudden, severe leg weakness, worsening back pain, and fecal incontinence. Alarming, right? This is more than a typical sciatica flare. As the team dives deeper, they uncover a medical maze—chronic vascular disease, prior urinary issues, new neurological deficits, and even a possible Guillain-Barré or neurosarcoidosis diagnosis on the table. With imaging revealing everything from spinal neuroforaminal narrowing to bilateral avascular necrosis and labs pointing to a urinary tract infection, this case demands clinical curiosity, multidisciplinary collaboration, and a whole-lot of critical thinking.

Key Topics for Clinical Learning:

• Differential Diagnosis of Sudden Neurologic Decline
  → How to evaluate lower extremity weakness with incontinence: spinal vs. autoimmune vs. infectious.

• Imaging Insights
  → MRI findings: Cervical to lumbar narrowing, femoral head necrosis, and how they connect (or don’t) to the clinical picture.

• Infectious Complications
  → Urinary tract infection or red herring? When to dig deeper.

• Labs & Pharmacology
  → Interpreting lab trends in complex cases and managing polypharmacy across neurology, vascular, and infectious disease concerns.

• Multidisciplinary Collaboration
  → Navigating consults between neurology, infectious disease, orthopedics, and internal medicine.