Document Detail


Does diagnosis change as a result of repeat renal colic computed tomography scan in patients with a history of kidney stones?
MedLine Citation:
PMID:  20223385     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: We sought to determine the incidence of alternative diagnosis in patients with a history of kidney stones who experience recurrent symptoms and undergo repeat computed tomography (CT) imaging at their return to the emergency department (ED). METHODS: This was a retrospective chart review of ED patients at a tertiary care hospital. Inclusion criteria were all adult ED patients who received a repeat CT for renal colic, after having previously received the diagnosis of obstructive kidney stone confirmed by CT, in our ED. Patients were identified by reviewing the charts of those patients with repeat visits to the ED after January 1, 2004, in which they complained of symptoms suggestive of renal colic and received a CT scan. We determined the frequency of the same diagnosis on repeat CT scan in this population compared with the frequency of alternative diagnosis. RESULTS: Two hundred thirty-one patients met criteria for the study. Fifty-nine percent were male. One hundred eighty-nine (81.8%) patients had no change in diagnosis as a result of a repeat renal colic CT scan. Twenty-seven (11.6%) patients received an alternative diagnosis that did not require urgent intervention, and 15 (6.5%) patients received a diagnosis that did require an urgent intervention. CONCLUSION: Repeat CT imaging of patients with known nephrolithiasis changed management in a minority of patients (6.5%). Knowing the frequency of alternative diagnosis in this population may help clinicians and patients balance the risks and benefits of repeat renal colic CT scans in patients with a history of kidney stones who return to the ED with similar symptoms.
Authors:
Adam Goldstone; Andrew Bushnell
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Publication Detail:
Type:  Journal Article     Date:  2010-01-28
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  28     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-12     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  291-5     Citation Subset:  IM    
Copyright Information:
2010 Elsevier Inc. All rights reserved.
Affiliation:
University of Vermont College of Medicine, Burlington, 05405, USA. adamgoldstonemd@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Diagnosis, Differential
Female
Humans
Kidney Calculi / radiography*
Male
Middle Aged
Recurrence
Renal Colic / radiography*
Retreatment
Retrospective Studies
Tomography, X-Ray Computed*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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