Variability of Imaging Modalities for Acute Flank Pain in the UK

2013 ◽  
Vol 95 (5) ◽  
pp. 1-3
Author(s):  
BW Turney ◽  
SR Keoghane
Keyword(s):  
Renal Colic ◽  
Imaging Modality ◽  
Intravenous Urography ◽  
Stone Disease ◽  
Rapid Diagnosis ◽  
Flank Pain ◽  
Acute Renal Colic ◽  
Unenhanced Computed Tomography ◽  
Acute Flank Pain ◽  
The Uk

The lifetime prevalence of acute renal colic in the UK has recently been estimated at around 11% and over 80,000 patients per year attend hospital in England with suspected renal colic. This leads to 1–2 presentations of acute flank pain every day to each hospital in the country. Rapid diagnosis will facilitate appropriate management. historically, intravenous urography (IVU) was the 'gold standard' investigation but this has been replaced in recent years by unenhanced computed tomography (CT-KUB). this has well-documented advantages over IVU as the imaging modality of choice in acute flank pain but is still not standard practice in all UK hospitals. the aim of this study was to establish the practical arrangements for imaging suspected stone disease in the UK.

scholarly journals Implications of Changing from Intravenous Urography to Computed Tomography as the Primary Imaging Modality for Acute Renal Colic

2013 ◽  
Vol 95 (2) ◽  
pp. 1-4
Author(s):  
SP McCombie ◽  
BW Turney ◽  
AM Rogers ◽  
IJ Lau ◽  
SPV Kumar
Keyword(s):  
Computed Tomography ◽  
Renal Impairment ◽  
Renal Colic ◽  
Imaging Modality ◽  
Intravenous Urography ◽  
Contrast Reaction ◽  
Acute Renal Colic ◽  
Unenhanced Computed Tomography ◽  
Higher Sensitivity

Several studies have shown that unenhanced computed tomography (CT), while having a similar specificity to intravenous urography (IVU) for detecting ureterolithiasis, has a much higher sensitivity. CT is also more effective in identifying alternative pathologies and is known to be a much quicker investigation to perform. Additionally, CT can be used in patients with renal impairment and carries no risk of contrast reaction.

scholarly journals Bilateral ureterolithiasis: A true positive and false negative PoCUS exam in a patient with renal colic

CJEM ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 957-961
Author(s):  
Matthew P. Lowe ◽  
Christopher Cox
Keyword(s):  
Renal Colic ◽  
Imaging Modality ◽  
Left Kidney ◽  
False Negative ◽  
Flank Pain ◽  
Point Of Care Ultrasound ◽  
Emergency Physicians ◽  
Ureteric Calculus ◽  
First Case ◽  
Acute Flank Pain

AbstractAcute flank pain from suspected urolithiasis is a common presenting complaint in the Emergency Department. Multiple computed tomography (CT) has traditionally been the standard imaging modality used to diagnose obstructive kidney stones, however point of care ultrasound (PoCUS) can play an important role in the diagnostic algorithm and risk stratification of acute flank pain. Here, we present the case of a 29-year-old female with suspected urolithiasis, who underwent PoCUS that revealed right-sided hydronephrosis and normal left kidney, bladder, and aorta. A subsequent KUB was negative. As the clinical course failed to improve with therapy, an abdominal and pelvic CT was ordered revealing a 5 mm distal obstructing ureteric calculus at the right vesico-ureteric junction and another 5 mm left mid ureteric calculus. To the best of our knowledge, this is the first case in which a patient presenting with acute right-sided flank pain demonstrated unilateral hydronephrosis on PoCUS, but had clinically significant bilateral ureteric stones on CT. Emergency physicians who employ PoCUS for evaluation of flank pain must be aware of its benefits and drawbacks and how they apply to each patient. As such, we have developed a script emergency physicians can use for shared decision-making with renal colic patients when deciding on the appropriate imaging modality.

scholarly journals THE ROLE OF ULTRASONOGRAPHY IN THE DETECTION OF UROLITHIASIS IN PATIENTS WITH ACUTE RENAL COLIC

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Sanjay Narayangiri Gosavi ◽  
Virendra K Meena ◽  
Ayush Tambi
Keyword(s):  
Ct Scan ◽  
Renal Colic ◽  
False Negative ◽  
Helical Ct ◽  
Urinary Stones ◽  
Predictive Values ◽  
Acute Renal Colic ◽  
Mean Size ◽  
Acute Flank Pain ◽  
Sensitivity Specificity

This study was conducted to assess the diagnostic Ultrasonography compared to unenhanced helical CT scan in detecting urinary stones in patients with acute renal colic. This retrospective study comprised of 156 patients who undergo unenhanced urinary tract CT scan and ultrasonography for thought of urolithiasis. Both techniques were used to resolve the presence or absence, site, size, and number of urinary stones, as well as company of any other intra-abdominal pathology. For statistical analysis, the sensitivity, specificity, predictive values, and diagnostic accuracy of ultrasonography were deliberate considering unenhanced CT scan as a gold normal. Unpaired two-tailed student’s t-test was used for judgment between mean size of true positive, false positive, and false negative stones. There were 68 patients having 115 urinary stones. Ultrasound identified 54 stones, missed 43, and falsely diagnosed 18 stones. The mean size of true positive, false positive, and false negative stones were 4.8 ± 3.3 mm, 6 ± 1.8 mm and 4.18 ± 3 mm, respectively. There were 23 patients with other intra-abdominal pathologies, equally detected by both techniques. Ultrasound helped in identifying the cause of acute flank pain in 62% of cases. The overall sensitivity, specificity, positive and negative predictive values, and correctness of ultrasonography in the diagnosis of renal stone disease were 58%, 91%, 79%, 78%, and 78%, respectively. Our study suggests that, despite its limited value in detecting urinary stones, ultrasonography should be performed as an initial assessment in patients with acute flank pain. Unenhanced helical CT should be reserved for patients in whom ultrasonography is uncertain. Keywords: Ultrasonography, CT scan

scholarly journals Management of acute renal colic in the UK: a questionnaire survey

2004 ◽  
Vol 4 (1) ◽  
Author(s):  
Tunji A Lasoye ◽  
Philip M Sedgwick ◽  
Nilay Patel ◽  
Chas Skinner ◽  
Nadeem Nayeem
Keyword(s):  
Questionnaire Survey ◽  
Renal Colic ◽  
Acute Renal Colic ◽  
The Uk

scholarly journals Predictive factors for stone disease in patients with renal colic

2017 ◽  
Vol 89 (2) ◽  
pp. 143 ◽  
Author(s):  
Hakan Türk ◽  
Sıtkı Ün
Keyword(s):  
Predictive Factors ◽  
Renal Colic ◽  
Urine Analysis ◽  
Urinary Stone ◽  
Stone Disease ◽  
Urinary System ◽  
Study Results ◽  
Acute Renal Colic ◽  
Nausea And Emesis ◽  
Group 2

Introduction: Many patients present to urology and emergency departments for acute renal colic complaints. There are many different imaging studies that can be used in patients with a pre-diagnosis of acute renal colic. In this study, we would like to assess the efficacy of using clinical and laboratory results in patients with flank pain complaint as a predictive factor of urinary system stone disease. Materials and methods: All patients were assessed using spinal non-contrast complete abdominal computerized tomography and urine analysis. Presence of stones and their number and size were recorded. Results: 516 patients who were included in the study were divided into 2 groups according to urinary stone presence. Group 1 (n = 388) consisted of patients with stones meanwhile patients in Group 2 (n = 128) were stone-free. According to these results, male sex, presence of microscopic hematuria, stone history in the family, nausea and emesis in addition to pain and accompanying urinary symptoms were detected as predictive factors in diagnosing urinary stone disease by multivariate analysis. Conclusion: From our study results, we can conclude that uroflowmetry is a very useful tool in monitoring lower urinary system complaints.

Alternative diagnoses to stone disease on unenhanced CT to investigate acute flank pain

2003 ◽  
Vol -1 (1) ◽  
pp. 1-1
Author(s):  
Mert Koroglu ◽  
John D. Wendel ◽  
Randy D. Ernst ◽  
Aytekin Oto
Keyword(s):  
Stone Disease ◽  
Flank Pain ◽  
Unenhanced Ct ◽  
Acute Flank Pain
Sign in / Sign up

Export Citation Format

Share Document