Cauda equina syndrome is a neurological emergency caused by compression of the nerve roots at the base of spine. Symptoms of cauda equina syndrome include numbness of the genitalia or one or both extremities and urinary incontinence. Stress urinary incontinence should be concerning for cauda equina and would require immediate action. Sharp stabbing back pain or crying and guarding of the back is often experienced with muscle strain or disk herniation, and while important, is not as concerning as possible cauda equina syndrome. Right flank tenderness is associated with urolithiasis and is not emergent.