Is the KUB radiograph redundant for investigating acute ureteric colic in the non-contrast enhanced computed tomography era?

Kennish, Steven; Bhatnagar, Priya; Wah, Tze Min; Bush, Stephen H.; Irving, Henry

doi:10.1016/j.crad.2008.04.012

Cited by 42 publications

(17 citation statements)

References 22 publications

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“…Numerous studies have shown that CT KUB is a diagnostically superior, safer, quicker and more cost-effective investigation for acute renal colic 2. However, computed tomography (CT) is a high radiation technique.…”

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confidence: 99%

Does the protocol for suspected renal colic lead to unnecessary radiation exposure of young female patients?

Patatas

2010

Emergency Medicine Journal

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Unenhanced multidetector computed tomography (CT KUB) is now firmly established as the best imaging method in the evaluation of suspected acute renal colic, and is replacing intravenous urography at an increasing number of hospitals. The female patient presenting at the emergency department with suspected acute renal colic presents a particular diagnostic problem, as the positive rate for stone disease in female patients is considerably lower compared with male patients. The indiscriminate use of suspected renal colic protocol and CT KUB in all female patients with flank pain should be avoided.

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confidence: 99%

Does the protocol for suspected renal colic lead to unnecessary radiation exposure of young female patients?

Patatas

2010

Emergency Medicine Journal

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“…Numerous studies have shown that CT KUB is a diagnostically superior, safer, quicker and more costeffective investigation for acute renal colic [2][3][4][5]. There is no need for intravenous contrast (and hence no risk of allergic or anaphylactic reaction, nor nephrotoxicity), the examination time is considerably shorter, there is increased sensitivity for the detection of calculi and other causes of pain can be detected.…”

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confidence: 99%

Emergency department imaging protocol for suspected acute renal colic: re-evaluating our service

Patatas¹,

Panditaratne²,

Wah³

et al. 2012

The British Journal of Radiology

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Objectives: The objective of our study is to determine the positive rate for urolithiasis in male and female patients, and evaluate whether there has been any change at our institution in the use and outcome of unenhanced multidetector CT (CT KUB) performed in the emergency department (ER) for patients presenting with suspected acute renal colic. Methods: A retrospective review of all 1357 consecutive cases between August 2007 and August 2009 admitted to the ER and investigated with CT KUB. Results: The positive rate for urolithiasis was 47.5% and the rate of other significant findings was 10%. Female patients had a significantly lower positive rate than male patients (26.8% vs 61.6%, p<0.001). Urological intervention was required in 37% and these patients had a larger average stone size. In young female patients with a significantly sized ureteric calculus (>4 mm), the presence of hydronephrosis vs no hydronephrosis was 83% vs 17%, respectively. Among them, only three patients required ureteroscopy for stone removal. Conclusion: Contrary to other studies there has been no “indication creep” in the use of CT KUB at our institution. However, the young female patient presenting with suspected urolithiasis presents a particular diagnostic problem, and the significant percentage of negative examinations in females implies that an improvement in current practice is needed. The indiscriminate use of CT KUB in all female patients with flank pain should be avoided, and it is suggested that they should be initially evaluated with ultrasound to detect the presence of hydronephrosis.

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“…Another study presented that KUB could demonstrate stones in only 59 % of patients who had a diagnosis of urolithiasis with computed tomography (CT) [ 1 ]. Based on this proof, Kennish et al argue that KUB should be omitted as a primary imaging method for ureteric colic if CT is available [ 2 ]. They recommend KUB for additional imaging in patients with urolithiasis diagnosed with CT.…”

Section: Introductionmentioning

confidence: 93%

Radiology Imaging for Ureteral Stones

Tepeler

Nakada

2014

Ureteral Stone Management

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Is the KUB radiograph redundant for investigating acute ureteric colic in the non-contrast enhanced computed tomography era?

Cited by 42 publications

References 22 publications

Does the protocol for suspected renal colic lead to unnecessary radiation exposure of young female patients?

Does the protocol for suspected renal colic lead to unnecessary radiation exposure of young female patients?

Emergency department imaging protocol for suspected acute renal colic: re-evaluating our service

Radiology Imaging for Ureteral Stones

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