The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients

Edmonds, Marcia L.; Yan, Justin; Sedran, Roberts J; McLeod, Shelley; Theakston, Karl D.

doi:10.1017/s1481803500012240

Cited by 47 publications

(36 citation statements)

References 32 publications

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“…This is higher than most of the studies done previously, Yan et al (1.55:1), Edmonds et al (1.14:1) and Kobayashi et al (1.68:1).9-11 Microscopic hematuria was seen in only 31% of the patients in the current study, which is much lower as compared to Yan et al (78.5%), Edmonds et al (60.3%), and Kobayashi et al (44.2%). [9][10][11] The mean age of presentation is lower in the current study (40.2), though the findings are similar to studies conducted by Edmonds at al where the age of presentation is 41.6 years of age. However, Kobayashi et al observed higher mean age (47.1).…”

Section: Discussionsupporting

confidence: 87%

“…However, Kobayashi et al observed higher mean age (47.1). [9][10][11] The ureteric calculus was most common in the VUJ (43%) and lower ureter (24%), and least common in mid ureter (13%) as observed on USG. The mean ureteric stone size was 7.2mm and serum creatinine levels were 0.85mg/dl which are similar to findings in other studies (Table 4).…”

Section: Discussionmentioning

confidence: 96%

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An observational study of incidence of urological intervention in patients of renal colic with normal and abnormal ultrasound study

Joshi

Srivastava

2018

Int Surg J

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Background: Renal colic is a common presentation that affects millions people annually. Although ultrasonography has lower sensitivity and specificity in diagnosing urolithiasis compared to CT, it is an alternative imaging modality that does not expose the patient to ionizing radiation. By this observational study an attempt has been made to know the incidence of urological intervention in suspected renal colic patients with normal USG findings, so as to decreasing the number of CT scans and associated ionizing radiation in patients with suspected renal colic.Methods: This was an observational study involving adult patients presenting to the Trauma and Emergency Care Department in Shree Krishna Hospital with suspected renal colic over a 12-months period. Renal ultrasonography was performed in suspected renal colic patients, and the results were categorized into three mutually exclusive groups: normal, suggestive of ureterolithiasis, or visualized ureteric stone. Patients were followed up to see if patients received urological intervention.Results: Of 132 patients enrolled, 16 (12.12%) were classified as normal; none of these patients underwent urologic intervention. 62 (46.92%) USG results were classified as suggestive of ureterolithiasis, and one (1.61%) patient received urologic intervention. A total of 54 (40.91%) USG results were classified as visualized ureteric stone, and 24 (44.45%) patients had urologic intervention. The rate of urologic intervention was significantly lower in those with normal USG results (p <0.001) than in those with abnormal findings.Conclusions: A normal renal ultrasonography predicts a low likelihood for urologic intervention for adult patients with suspected renal colic.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 96%

An observational study of incidence of urological intervention in patients of renal colic with normal and abnormal ultrasound study

Joshi

Srivastava

2018

Int Surg J

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“…This often indicated calculi are present with a sensitivity nearing one hundred percent (Edmonds, Yan, Sedran, McLeod, & Theakston, 2010). The study took place at a multi-campus academic teirtary care center in Ontario, Canada.…”

Section: Ultrasonographymentioning

confidence: 99%

Computed Tomographic Scans on Patients with Repeat Renal Calculi: A Pilot Study

Reposa

2016

Preprint

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Patients at risk for repeat renal calculi presenting to the ED with symptoms similar to their previous episodes, are likely to be over-exposed to computed tomographic (CT) scans. With recurrence at fifty percent minimizing CT use in this population is imperative (Goertz & Lotterman, 2010). Studies indicate using urinalysis and alternative imaging methods are necessary to prevent increases in radiation exposure, cost and ED visit time.The purpose of the project was to decrease CT use by providing current evidence-based research to ED providers on the overuse of CT scans for patients with a history of renal calculi who present with symptoms comparable to previous episodes. Using the logical model, the project was a retrospective chart review. The study took place in Charlton Memorial Hospital's ED. Charts were reviewed of patients who had a history of renal calculi and presented to the ED with flank pain. Patients were excluded for age less than eighteen, recent surgery, and chronic renal failure and/or dialysis due to renal impairment at baseline. The pre-presentation chart review was to assess the need to decrease CT scan ordering in the given population. An informational session on current research was provided to the providers and a post presentation chart review was completed to evaluate if there was a subsequent decrease in CT ordering. The study proved using evidencebased research to educate providers could result in a decreased amount of CT scans ordered. CT scans were ordered, eighty percent pre-presentation and decreased to sixtyfive percent post.

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“…This has been suggested for the investigation of appendicitis and urolithiasis. 10,11 When nonionizing imaging modalities are not feasible, the next best option is a test that minimizes radiation exposure.…”

Section: ])mentioning

confidence: 99%

Familiarity with radiation exposure dose from diagnostic imaging for acute pulmonary embolism and current patterns of practice

Ahn

Edmonds

McLeod

et al. 2014

CJEM

Self Cite

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Objective: To assess the current level of knowledge and practice patterns of emergency physicians regarding radiation exposure from diagnostic imaging modalities for investigating acute pulmonary embolism (PE). Methods: An online survey was sent to adult emergency physicians working at two academic tertiary care adult emergency departments (EDs) to determine imaging choices for investigating PE in various patient populations and to assess their current knowledge of radiation doses and risks. A retrospective chart review was performed for all adult patients who underwent computed tomographic pulmonary angiography (CTPA) and/or ventilation-perfusion (V/Q) scanning in the same EDs. Results: The survey response rate was 72.1% (31 of 43 physicians). For patients , 30 years old, 83.9% of physicians chose V/Q scanning as their test of choice, regardless of gender. Although only a third of respondents knew the estimated radiation dose of a V/Q scan (37.5%) and a CTPA (32%), the majority were aware that V/Q scans involved less ionizing radiation than CTPAs. In the retrospective review, 663 charts were reviewed, including 201 CTPAs and 462 V/Q scans. V/Q scanning was the preferred modality in female patients (75.9% v. CTPA 24.1% [OR 2.1; 95% CI 1.5-2.9]) and in patients , 30 years old (87.9% v. CTPA 12.1% [OR 4.8; ]).Conclusions: Although surveyed physicians possessed limited knowledge of radiation doses of CTPA and V/Q scans, they preferentially used the lower radiation V/Q scans in younger patients, particularly females, in both the survey vignettes and in clinical practice. This may reflect efforts to reduce radiation exposures at our institution. RÉ SUMÉObjectif: L'é tude visait à é valuer le degré de connaissances des urgentologues et leur pratique en ce qui concerne l'exposition au rayonnement é mis par les diffé rents types d'imagerie diagnostique, dans le contexte de l'embolie pulmonaire (EP) aiguë . Mé thodes: Un questionnaire d'enquê te en ligne a é té envoyé à des urgentologues travaillant dans deux services d'urgence (SU) universitaires, de soins tertiaires, pour adultes, visant à dé terminer le type choisi d'imagerie pour confirmer la pré sence d'une EP dans diffé rents groupes de patients, et à é valuer leur degré de connaissances sur les doses de rayonnement et leurs risques. Nous avons procé dé à un examen ré trospectif des dossiers mé dicaux de tous les adultes ayant subi une angiographie pulmonaire par tomodensitomé trie (APTDM) et/ou une scintigraphie de ventilation et de perfusion (VA/Q) dans ces mê mes SU. Ré sultats: Le taux de ré ponse a atteint 72.1% (31 mé decins sur 43). Chez les patients de moins de 30 ans, 83.9% des mé decins ont choisi la scintigraphie de VA/Q comme examen de premiè re intention, indé pendamment du sexe. Un tiers seulement des ré pondants connaissait la dose estimé e de rayonnement de la scintigraphie de VA/Q (37.5%) et de l'APTDM (32%), mais la majorité savait que la scintigraphie de VA/Q é mettait moins de rayonnement ionisant que l'APTDM. ]).Conclusions: Les mé dec...

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The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients

Cited by 47 publications

References 32 publications

An observational study of incidence of urological intervention in patients of renal colic with normal and abnormal ultrasound study

An observational study of incidence of urological intervention in patients of renal colic with normal and abnormal ultrasound study

Computed Tomographic Scans on Patients with Repeat Renal Calculi: A Pilot Study

Familiarity with radiation exposure dose from diagnostic imaging for acute pulmonary embolism and current patterns of practice

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