Document Detail


The efficacy of urinalysis, plain films, and spiral CT in ED patients with suspected renal colic.
MedLine Citation:
PMID:  12671819     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We determined the diagnostic value of urinalysis and plain films in patients with suspected renal colic presenting to an emergency department (ED). Over a 1-year period, 138 patients presented to the ED during the daytime with suspected renal colic, but for technical reasons the diagnostic modalities used in the study could be completed for only 99 patients, and 34 patients were lost to follow-up. A urinalysis; kidney, ureter, and bladder film; and spiral computed tomography (CT) were performed on each patient. The presence of urinary tract stones was determined by their definite presence on helical CT and/or passage of a stone on clinical follow-up (average follow-up = 3 months). A urinary stone was visualized on spiral CT or passed in the urine in 54 of the patients. Using helical CT findings or passage of a stone as the gold standard, plain radiography had a sensitivity of 69% and specificity of 82%. Urinalysis had a sensitivity of 69% and specificity of 27%. The sensitivity increased to 89% if either test was positive, but the specificity remained low at 27%. The sensitivity and specificity of CT in the diagnosis of urinary stones was 91%. Urinalysis and plain films are much less accurate than helical CT for confirming the diagnosis of acute urolithiasis. Further evaluation of the clinical and cost-effectiveness of helical CT should be done to determine its role in the work-up of these patients.
Authors:
Oktay Eray; Metin S Cubuk; Cem Oktay; Saim Yilmaz; Yildiray Cete; F Fevzi Ersoy
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  21     ISSN:  0735-6757     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-04-02     Completed Date:  2003-05-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  152-4     Citation Subset:  IM    
Copyright Information:
Copyright 2003, Elsevier Science (USA). All rights reserved.)
Affiliation:
Department of Emergency Medicine, Akdeniz University School of Medicine, Antalya, Turkey. oeray@med.akdeniz.edu.tr
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MeSH Terms
Descriptor/Qualifier:
Adult
Colic / diagnosis*,  radiography
Female
Flank Pain / etiology
Humans
Kidney Diseases / diagnosis*,  radiography
Male
Prospective Studies
Sensitivity and Specificity
Tomography, Spiral Computed
Urinalysis
Urinary Calculi / complications,  diagnosis*,  radiography
Urography

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


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