Document Detail


Unenhanced CT for the evaluation of acute ureteric colic: the essential pictorial guide.
MedLine Citation:
PMID:  20634253     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Acute ureteric colic is a common emergency, often dealt with by the emergency physician or general practitioner and referred on to the urologist. Unenhanced CT of the kidneys, ureters and bladder (CTKUB) is the 'gold standard' imaging investigation for establishing a diagnosis and guiding management. An appreciation of the CTKUB signs, which support or refute a diagnosis of ureteric colic, is highly valuable to the clinician when making a urological referral, and to the urologist, who must make appropriate management plans. All salient diagnostic and supportive features of ureteric colic are carefully illustrated, as are important radiological mimics, with the objectives of educating and informing the non-radiologist. Ready access to the picture archive and communication system (PACS) allows all specialists involved to interpret the radiological report with the benefit of images. A stone within the ureter may not always be readily apparent. Soft tissue rim sign around a calcific focus is an important indicator of a ureteric stone, whereas a comet tail sign suggests a phlebolith (a calcified venous thrombosis), a radiological mimic of a ureteric stone. Numerous secondary signs of ureteric obstruction may be present including hydronephrosis and perinephric stranding, and can help to confirm the diagnosis. The relative diagnostic weighting of signs is discussed, and a checklist is provided to assist with interpretation. Unexpected alternative radiological diagnoses are also illustrated, which may have significant management consequences necessitating specialist referral.
Authors:
Steven J Kennish; Tze M Wah; Henry C Irving
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Postgraduate medical journal     Volume:  86     ISSN:  1469-0756     ISO Abbreviation:  Postgrad Med J     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-16     Completed Date:  2010-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0234135     Medline TA:  Postgrad Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  428-36     Citation Subset:  IM    
Affiliation:
Leeds Teaching Hospitals, Leeds Radiology Academy, Clarendon Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK. s_kennish@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Colic / pathology,  radiography*
Edema / pathology,  radiography
Humans
Tomography, X-Ray Computed / methods*
Ureteral Calculi / pathology,  radiography
Ureteral Diseases / pathology,  radiography*

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


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