A 40-year-old woman presents with mid-back pain and weakness in her legs. She also reports a recent loss of sensation in her legs and has had trouble controlling her bladder. On examination, there is decreased sensation below the waist and hyperreflexia in the lower limbs. What could be the diagnosis and the next steps?
This patient's presentation is suggestive of a spinal cord lesion, likely in the thoracic region. Given her age, the location of her symptoms, and her gender, one should consider the possibility of a thoracic disc herniation or a spinal cord tumor. An urgent MRI is warranted to determine the cause of her symptoms. Depending on the findings, she may require high-dose corticosteroids, neurosurgical consultation, and possibly surgery.