Comprehensive Osteopathic Medical Licensing Examination (COMLEX USA) Practice

Which of the following symptoms is characteristic of saddle numbness?

1. Numbness of the hands and fingers

2. Numbness in the buttocks and inner thighs

3. Numbness in the feet

4. Numbness only in the lower back

The correct answer is: Numbness in the buttocks and inner thighs

Saddle numbness is a specific type of sensory disturbance that is associated with issues affecting the lower spinal regions, particularly the areas innervated by the sacral nerves. This symptom typically presents as numbness or a loss of sensation in the regions of the body that would come into contact with a saddle—namely, the buttocks and the inner thighs. This distribution is key in differentiating saddle numbness from other types of numbness. In conditions such as cauda equina syndrome or significant spinal cord compression, saddle numbness can be an important clinical sign that may indicate underlying neurologic compromise. This symptom often accompanies other signs such as bladder or bowel dysfunction, suggesting that critical structures may be affected. While numbness of the hands and fingers is often indicative of cervical spine issues or peripheral neuropathy, and numbness in the feet may point towards diabetic neuropathy or lower extremity nerve compressions, neither of these scenarios fits the description of saddle numbness. Numbness only in the lower back would not encompass the characteristic distribution associated with saddle numbness either. Thus, the specific presentation of numbness in the buttocks and inner thighs is both distinct and significant when assessing for neurological concerns involving the lower sacral regions.