Rationale use of unenhanced multi-detector CT (CT KUB) in evaluation of suspected renal colic

Nadeem, Mehwash; Ather, M Hammad; Jamshaid, Anila; Zaigham, Samrah; Mirza, Rabeea; Salam, Basit

doi:10.1016/j.ijsu.2012.10.007

Cited by 18 publications

(17 citation statements)

References 23 publications

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“…In our sample, 10% of women had an alternative diagnosis on low-dose unenhanced CT compared to 5% of men. Although this difference was not statistically significant, it is consistent with previous reports: Nadeem and colleagues reported a higher rate of incidental findings in women, 21 and…”

Section: Discussionsupporting

confidence: 92%

“…Nadeem and colleagues reported that unenhanced CT yielded an incidental diagnosis rate of 18% in studies ordered by emergency physicians. 21 Three retrospective studies reported that the proportion of cases with an alternative diagnosis ranged between 8 and 12%. 19,22,23 The reluctance of physicians to systematically obtain CT scans for suspected uncomplicated renal colic is likely, at least in part, to be due to efforts to limit radiation exposure, particularly in young women.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study

Pernet

Abergel

Parra

et al. 2015

CJEM

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Objectives: Unenhanced computed tomography (CT) has become a standard imaging technique for uncomplicated renal colic in many countries. The appropriate timing of CT imaging has not been established, and guidelines recommend that this imaging be performed between 1 and 7 days of presentation. The primary objective of this study was to determine the prevalence of alternative diagnosis identified with low-dose unenhanced CT in the emergency department (ED) in patients with suspected uncomplicated renal colic. Methods: This prospective single-centre study was carried out in a large university hospital ED. Over a 6-month period, all patients with clinically diagnosed renal colic and a plan to be discharged underwent low-dose unenhanced CT in the ED. Pregnant women, women of childbearing age not willing to have a pregnancy test, and patients who had already undergone diagnostic imaging were excluded. The primary outcome was the number and nature of the alternative diagnosis. Univariate analyses were performed to assess factors associated with the primary outcome. Results: A total of 178 patients were screened, and 155 underwent CT in the ED. The mean age was 42.2 years; 69% were male. The diagnosis of uncomplicated renal colic was confirmed in 118 participants (76%); 27 (17%) had an inconclusive CT scan. Overall, 10 patients (6%; 95% confidence interval [CI] 3-10) had an alternative diagnosis, 5 of whom were subsequently hospitalized. Conclusion: Low-dose unenhanced CT in the ED detects alternative diagnoses in 6% (95% CI 3-10) of patients with suspected uncomplicated renal colic, half of whom are subsequently hospitalized. Our prospective findings, which were similar to those reported in retrospective studies, are a potential argument for a systematic approach to ED imaging in suspected renal colic. Future research involving intervention and control groups would be helpful. RÉ SUMÉObjectif: La tomodensitomé trie (TDM) sans densification est devenue, dans de nombreux pays, une technique d'imagerie courante dans les cas de colique né phré tique sans complications. Toutefois, le moment propice pour faire passer cet examen n'est pas é tabli, et, d'aprè s les lignes directrices, l'examen devrait ê tre effectué entre le premier et le septiè me jour de la consultation. L'é tude avait pour objectif principal de dé terminer la pré valence d'autres diagnostics que celui de colique né phré tique sans complications, posé s dans des cas pré sumé s, à l'aide de la TDM sans densification à faible dose, au service des urgences (SU). Mé thode: Il s'agit d'une é tude prospective, unicentrique, qui a é té mené e dans un SU d'un important centre hospitalier universitaire. Sur une pé riode de 6 mois, tous les patients chez qui un diagnostic clinique de colique né phré tique avait é té posé et pour lesquels la sortie é tait pré vue ont passé une TDM sans densification à faible dose au SU. Les femmes enceintes, celles en â ge de procré er qui ne souhaitaient pas passer un test de grossesse et les patients qui avaient dé jà subi de...

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study

Pernet

Abergel

Parra

et al. 2015

CJEM

View full text Add to dashboard Cite

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“…Previous technologies, including US, necessary X‐ray examination, and plain KUB radiographs, have been demonstrated to be limited by several constraining factors in accurately diagnosing upper urinary tract calculi and in determining the size, composition, amount and position of the calculi, bowel content, obstruction, and infection, etc. . Theoretically, 90% of stones can be found by X‐ray and KUB, however the actual display rate of both have been shown to be lower than actual rates, thereby seriously hindering the diagnosis of calculi .…”

Section: Discussionmentioning

confidence: 99%

“…Frequently, the true prevalence of urinary calculi is underestimated because many calculi remain asymptomatic and hence go undiagnosed . Generally, the great majority of patients with urinary calculi can be diagnosed, to some extent, through medical history, physical examination, ultrasound, or X‐ray examination . However, several factors constraint diagnostic accuracy, including the size, amount and position of the calculi, bowel content of patient, obstruction and infection, as well as calculi composition, etc.…”

Section: Introductionmentioning

confidence: 99%

In Vivo Evaluation of Chemical Composition of Eight Types of Urinary Calculi Using Spiral Computerized Tomography in a Chinese Population

Hashimoto

Liu

Wang

et al. 2014

Clinical Laboratory Analysis

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“…DOI: 10.18410/jebmh/2019/354 BACKGROUND Renal stones are very common, affecting 12% of the population at some point of time in their life. 1,2 The most common type of stone is calcium oxalate (60-80%). 3 The aetiology of formation is largely unknown.…”

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confidence: 99%

Evaluation of Urinary Tract Calculi by Sonological and Plain Abdominal Radiography- An Observational Study

Krishnappa¹,

Harish²

2019

jebmh

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BACKGROUND Urolithiasis is very common, affecting 12% of the population at some point of time in their life. The most common type of stone is calcium oxalate (60-80%). X-ray & ultrasound were most commonly used to diagnostic tools to pinpoint the urinary tract calculi & decrease the incidences of false diagnosis. METHODS Plain x-ray and ultrasound evaluation in the diagnosis of urinary tract calculi was conducted between September 2006 to August 2008. This study was conducted at Adichunchanagiri Institute of Medical Sciences, B.G. Nagar, Mandya. 35 patients included in the study were subjected to plain x-ray & ultrasound. RESULTS Total number of patients was 35, out of which 19 were female (54.28%) & 16 patients were male (45.71%) respectively. Age of the patients varied from 13 to 77 yrs. Out of 35 patients, 16 had ureteric calculi (35%), 11 had renal with ureteric calculi (31.4%), 4 had vesical calculus (11.4%) and 4 had calculus in PUJ (11.4%). 74.2% cases were diagnosed as urinary tract calculi by x-ray & 82.8% cases were diagnosed by ultrasound respectively. CONCLUSIONS Ultrasonography has more accuracy than plain x-ray in diagnosing urinary tract calculi. When both investigations were combined, accuracy rate further increased.

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Rationale use of unenhanced multi-detector CT (CT KUB) in evaluation of suspected renal colic

Cited by 18 publications

References 23 publications

Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study

Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study

In Vivo Evaluation of Chemical Composition of Eight Types of Urinary Calculi Using Spiral Computerized Tomography in a Chinese Population

Evaluation of Urinary Tract Calculi by Sonological and Plain Abdominal Radiography- An Observational Study

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