The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients
Computed tomography (CT) is an imaging modality used to detect renal stones. However, there is concern about the lifetime cumulative radiation exposure attributed to CT. Ultrasonography (US) has been used to diagnose urolithiasis, thereby avoiding radiation exposure. The objective of this study was...
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| Veröffentlicht in: | Canadian journal of emergency medicine 2010-05, Vol.12 (3), p.201-206 |
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| creator | Edmonds, Marcia L. Yan, Justin W. Sedran, Robert J. McLeod, Shelley L. Theakston, Karl D. |
| description | Computed tomography (CT) is an imaging modality used to detect renal stones. However, there is concern about the lifetime cumulative radiation exposure attributed to CT. Ultrasonography (US) has been used to diagnose urolithiasis, thereby avoiding radiation exposure. The objective of this study was to determine the ability of US to identify renal colic patients with a low risk of requiring urologic intervention within 90 days of their initial emergency department (ED) visit.
We completed a retrospective medical record review for all adult patients who underwent ED-ordered renal US for suspected urolithiasis over a 1-year period. Independent, double data extraction was performed for all imaging reports and US results were categorized as "normal," "suggestive of ureterolithiasis," "ureteric stone seen" or "disease unrelated to urolithiasis." Charts were reviewed to determine how many patients underwent subsequent CT and urologic intervention.
Of the 817 renal US procedures ordered for suspected urolithiasis during the study period, the results of 352 (43.2%) were classified as normal, and only 2 (0.6%) of these patients required urologic intervention. The results of 177 (21.7%) renal US procedures were suggestive of ureterolithiasis. Of these, 12 (6.8%) patients required urologic intervention. Of the 241 (29.5%) patients who had a ureteric stone seen on US, 15 (6.2%) required urologic intervention. The rate of urologic intervention was significantly lower in those with normal results on US (p < 0.001) than in those with abnormal results on US.
A normal result on renal US predicts a low likelihood for urologic intervention within 90 days for adult ED patients with suspected urolithiasis. |
| doi_str_mv | 10.1017/S1481803500012240 |
| format | Article |
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We completed a retrospective medical record review for all adult patients who underwent ED-ordered renal US for suspected urolithiasis over a 1-year period. Independent, double data extraction was performed for all imaging reports and US results were categorized as "normal," "suggestive of ureterolithiasis," "ureteric stone seen" or "disease unrelated to urolithiasis." Charts were reviewed to determine how many patients underwent subsequent CT and urologic intervention.
Of the 817 renal US procedures ordered for suspected urolithiasis during the study period, the results of 352 (43.2%) were classified as normal, and only 2 (0.6%) of these patients required urologic intervention. The results of 177 (21.7%) renal US procedures were suggestive of ureterolithiasis. Of these, 12 (6.8%) patients required urologic intervention. Of the 241 (29.5%) patients who had a ureteric stone seen on US, 15 (6.2%) required urologic intervention. The rate of urologic intervention was significantly lower in those with normal results on US (p < 0.001) than in those with abnormal results on US.
A normal result on renal US predicts a low likelihood for urologic intervention within 90 days for adult ED patients with suspected urolithiasis.</description><identifier>ISSN: 1481-8035</identifier><identifier>EISSN: 1481-8043</identifier><identifier>DOI: 10.1017/S1481803500012240</identifier><identifier>PMID: 20522284</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Adult ; Colic ; CT imaging ; Diagnostic imaging ; EM Advances ; Emergencies ; Emergency service ; Female ; Hospitals ; Humans ; Kidney stones ; Male ; Medical records ; Medical research ; Medicine, Experimental ; Middle Aged ; Ontario ; Original Research • Recherche originale ; Pain ; Radiation ; Radiation Injuries - prevention & control ; Renal Colic - diagnostic imaging ; Renal Colic - etiology ; Reproducibility of Results ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonic imaging ; Ultrasonography ; Ureterolithiasis - complications ; Ureterolithiasis - diagnostic imaging ; Urolithiasis - complications ; Urolithiasis - diagnostic imaging ; Urology</subject><ispartof>Canadian journal of emergency medicine, 2010-05, Vol.12 (3), p.201-206</ispartof><rights>Copyright © Canadian Association of Emergency Physicians 2010</rights><rights>COPYRIGHT 2010 Decker Publishing</rights><rights>Copyright Canadian Medical Association May 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c628t-bd7bc3307a767ec0764d7d9c04c6c074653ceeb2042ddf4573dcd4f597ecd0aa3</citedby><cites>FETCH-LOGICAL-c628t-bd7bc3307a767ec0764d7d9c04c6c074653ceeb2042ddf4573dcd4f597ecd0aa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20522284$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Edmonds, Marcia L.</creatorcontrib><creatorcontrib>Yan, Justin W.</creatorcontrib><creatorcontrib>Sedran, Robert J.</creatorcontrib><creatorcontrib>McLeod, Shelley L.</creatorcontrib><creatorcontrib>Theakston, Karl D.</creatorcontrib><title>The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients</title><title>Canadian journal of emergency medicine</title><addtitle>Can J Emergen Med</addtitle><description>Computed tomography (CT) is an imaging modality used to detect renal stones. However, there is concern about the lifetime cumulative radiation exposure attributed to CT. Ultrasonography (US) has been used to diagnose urolithiasis, thereby avoiding radiation exposure. The objective of this study was to determine the ability of US to identify renal colic patients with a low risk of requiring urologic intervention within 90 days of their initial emergency department (ED) visit.
We completed a retrospective medical record review for all adult patients who underwent ED-ordered renal US for suspected urolithiasis over a 1-year period. Independent, double data extraction was performed for all imaging reports and US results were categorized as "normal," "suggestive of ureterolithiasis," "ureteric stone seen" or "disease unrelated to urolithiasis." Charts were reviewed to determine how many patients underwent subsequent CT and urologic intervention.
Of the 817 renal US procedures ordered for suspected urolithiasis during the study period, the results of 352 (43.2%) were classified as normal, and only 2 (0.6%) of these patients required urologic intervention. The results of 177 (21.7%) renal US procedures were suggestive of ureterolithiasis. Of these, 12 (6.8%) patients required urologic intervention. Of the 241 (29.5%) patients who had a ureteric stone seen on US, 15 (6.2%) required urologic intervention. The rate of urologic intervention was significantly lower in those with normal results on US (p < 0.001) than in those with abnormal results on US.
A normal result on renal US predicts a low likelihood for urologic intervention within 90 days for adult ED patients with suspected urolithiasis.</description><subject>Adult</subject><subject>Colic</subject><subject>CT imaging</subject><subject>Diagnostic imaging</subject><subject>EM Advances</subject><subject>Emergencies</subject><subject>Emergency service</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Kidney stones</subject><subject>Male</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Ontario</subject><subject>Original Research • Recherche originale</subject><subject>Pain</subject><subject>Radiation</subject><subject>Radiation Injuries - prevention & control</subject><subject>Renal Colic - diagnostic imaging</subject><subject>Renal Colic - etiology</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Tomography, X-Ray Computed</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><subject>Ureterolithiasis - complications</subject><subject>Ureterolithiasis - diagnostic imaging</subject><subject>Urolithiasis - complications</subject><subject>Urolithiasis - diagnostic imaging</subject><subject>Urology</subject><issn>1481-8035</issn><issn>1481-8043</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp10k1v1DAQBmALgWhZ-AFcUFQOiEOKP-PssapaqFTBoeVsOfYkdZXEqe1I3X-Po11KFxbl4Nh-ZiS_GoTeE3xKMJFfbgivSY2ZwBgTSjl-gY6Xo7LGnL18-mfiCL2J8X5BgtSv0RHFglJa82MEt3dQzMn1Lm0K3xYBRt0Xc5-Cjn70XdDT3aZwY5Gys053o48u_pHG984s9zBA6GA0m8LCpEMaYEzFpJPLa3yLXrW6j_But67Qz8uL2_Nv5fWPr1fnZ9elqWidysbKxjCGpZaVBINlxa20a4O5qfKOV4IZgIZiTq1tuZDMGstbsc7YYq3ZCn3a9p2Cf5ghJjW4aKDv9Qh-jkoyljOhss7y5C957-eQXxQVWQu5FlXObYU-blGne1BubH2OxSwt1RmlQnLMpMiqPKByFhB070doXT7e8ycHvJncg3qOTg-g_FkYnDnY9fNeQTYJHlOn5xjV1c33fUu21gQfY4BWTcENOmwUwWqZLPXPZOWaD7vA5mYA-1Txe5QyYLumemiCsx08i_S_bX8BB7vUiQ</recordid><startdate>20100501</startdate><enddate>20100501</enddate><creator>Edmonds, Marcia L.</creator><creator>Yan, Justin W.</creator><creator>Sedran, Robert J.</creator><creator>McLeod, Shelley L.</creator><creator>Theakston, Karl D.</creator><general>Cambridge University Press</general><general>Decker Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISN</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>8FV</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M3G</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20100501</creationdate><title>The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients</title><author>Edmonds, Marcia L. ; Yan, Justin W. ; Sedran, Robert J. ; McLeod, Shelley L. ; Theakston, Karl D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c628t-bd7bc3307a767ec0764d7d9c04c6c074653ceeb2042ddf4573dcd4f597ecd0aa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Colic</topic><topic>CT imaging</topic><topic>Diagnostic imaging</topic><topic>EM Advances</topic><topic>Emergencies</topic><topic>Emergency service</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Kidney stones</topic><topic>Male</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Ontario</topic><topic>Original Research • Recherche originale</topic><topic>Pain</topic><topic>Radiation</topic><topic>Radiation Injuries - prevention & control</topic><topic>Renal Colic - diagnostic imaging</topic><topic>Renal Colic - etiology</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Tomography, X-Ray Computed</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><topic>Ureterolithiasis - complications</topic><topic>Ureterolithiasis - diagnostic imaging</topic><topic>Urolithiasis - complications</topic><topic>Urolithiasis - diagnostic imaging</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Edmonds, Marcia L.</creatorcontrib><creatorcontrib>Yan, Justin W.</creatorcontrib><creatorcontrib>Sedran, Robert J.</creatorcontrib><creatorcontrib>McLeod, Shelley L.</creatorcontrib><creatorcontrib>Theakston, Karl D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Canada</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business & Current Affairs Database</collection><collection>Canadian Business & Current Affairs Database (Alumni Edition)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>CBCA Reference & Current Events</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Canadian journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Edmonds, Marcia L.</au><au>Yan, Justin W.</au><au>Sedran, Robert J.</au><au>McLeod, Shelley L.</au><au>Theakston, Karl D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients</atitle><jtitle>Canadian journal of emergency medicine</jtitle><addtitle>Can J Emergen Med</addtitle><date>2010-05-01</date><risdate>2010</risdate><volume>12</volume><issue>3</issue><spage>201</spage><epage>206</epage><pages>201-206</pages><issn>1481-8035</issn><eissn>1481-8043</eissn><abstract>Computed tomography (CT) is an imaging modality used to detect renal stones. However, there is concern about the lifetime cumulative radiation exposure attributed to CT. Ultrasonography (US) has been used to diagnose urolithiasis, thereby avoiding radiation exposure. The objective of this study was to determine the ability of US to identify renal colic patients with a low risk of requiring urologic intervention within 90 days of their initial emergency department (ED) visit.
We completed a retrospective medical record review for all adult patients who underwent ED-ordered renal US for suspected urolithiasis over a 1-year period. Independent, double data extraction was performed for all imaging reports and US results were categorized as "normal," "suggestive of ureterolithiasis," "ureteric stone seen" or "disease unrelated to urolithiasis." Charts were reviewed to determine how many patients underwent subsequent CT and urologic intervention.
Of the 817 renal US procedures ordered for suspected urolithiasis during the study period, the results of 352 (43.2%) were classified as normal, and only 2 (0.6%) of these patients required urologic intervention. The results of 177 (21.7%) renal US procedures were suggestive of ureterolithiasis. Of these, 12 (6.8%) patients required urologic intervention. Of the 241 (29.5%) patients who had a ureteric stone seen on US, 15 (6.2%) required urologic intervention. The rate of urologic intervention was significantly lower in those with normal results on US (p < 0.001) than in those with abnormal results on US.
A normal result on renal US predicts a low likelihood for urologic intervention within 90 days for adult ED patients with suspected urolithiasis.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>20522284</pmid><doi>10.1017/S1481803500012240</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Colic CT imaging Diagnostic imaging EM Advances Emergencies Emergency service Female Hospitals Humans Kidney stones Male Medical records Medical research Medicine, Experimental Middle Aged Ontario Original Research • Recherche originale Pain Radiation Radiation Injuries - prevention & control Renal Colic - diagnostic imaging Renal Colic - etiology Reproducibility of Results Retrospective Studies Tomography, X-Ray Computed Ultrasonic imaging Ultrasonography Ureterolithiasis - complications Ureterolithiasis - diagnostic imaging Urolithiasis - complications Urolithiasis - diagnostic imaging Urology |
| title | The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients |
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