Utility of hematuria testing in patients with suspected renal colic: correlation with unenhanced helical CT results

Luchs, Jonathan S.; Katz, Douglas S.; Lane, Michael J.; Mellinger, Brett C.; Lumerman, Jeffrey H.; Stillman, Charles A; Meiner, Evan M.; Perlmutter, Steven

doi:10.1016/s0090-4295(02)01558-3

Cited by 69 publications

(38 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results support the conclusion of Luchs et al 8 that the presence or absence of haematuria on urinalysis cannot be used to diagnose urolithiasis accurately and should not be used to decide who should undergo unenhanced CT scanning.…”

Section: Discussionsupporting

confidence: 89%

“…At our university hospital all patients who are diagnosed with urolithiasis are referred directly to the Department of Urology for secondary pain relief and definitive treatment within the next 24 h. The Department of Urology accepts the referrals only when a CT scan has been performed. Previous comparisons of the diagnostic value of microhaematuria versus radiological studies have yielded conflicting results, largely due to different urine testing methods, use of different radiological examinations as gold standard and differences in the patient populations studied 2 8 – 12. We therefore evaluated urinalysis as a diagnostic test in patients presenting to the emergency department with clinically suspected urolithiasis using unenhanced multidetector computed tomography (MDCT) scans as the reference standard.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Forget the blood, not the stone! Microhaematuria in acute urolithiasis and the role of early CT scanning

Xafis

Thalmann

Benneker

et al. 2008

Emergency Medicine Journal

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Forget the blood, not the stone! Microhaematuria in acute urolithiasis and the role of early CT scanning

Xafis

Thalmann

Benneker

et al. 2008

Emergency Medicine Journal

View full text Add to dashboard Cite

show abstract

“…While most ureteral stones will pass without consequence, the challenge for emergency physicians (EP) is to identify those patients who are at higher risk for complications, such as obstructive uropathy. Microscopic hematuria on UA is a good screening test in the workup of suspected ureteral colic, but its sensitivity ranges between 69% and 84%,3,9 similar to the rate found in our study of 82%.…”

Section: Discussionsupporting

confidence: 87%

“…The evaluation of urolithiasis is largely influenced by the results of a urinalysis (UA). While the presence of microscopic hematuria favors a diagnosis of urolithiasis in a patient presenting with symptoms suggestive of ureteral colic, it is estimated that 10–20% of patients with urolithiasis can present without microscopic hematuria on UA 3. To the best of our knowledge, there are no large studies examining whether the presence or absence of microscopic hematuria has any influence on the likelihood of a patient having concomitant clinically significant hydronephrosis.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Urolithiasis in the Presence and Absence of Microscopic Hematuria in the Emergency Department

Mefford¹,

Tungate²,

Amini³

et al. 2017

WestJEM

View full text Add to dashboard Cite

IntroductionUrolithiasis is a common medical condition that accounts for a large number of emergency department (ED) visits each year and contributes significantly to annual healthcare costs. Urinalysis is an important screening test for patients presenting with symptoms suspicious for urolithiasis. At present there is a paucity of medical literature examining the characteristics of ureteral stones in patients who have microscopic hematuria on urinalysis versus those who do not. The purpose of this study was to examine mean ureteral stone size and its relationship to the incidence of clinically significant hydronephrosis in patients with and without microscopic hematuria.MethodsThis is a retrospective chart review of patient visits to a single, tertiary academic medical center ED between July 1, 2008, and August 1, 2013, of patients who underwent non-contrast computed tomography of the abdomen and pelvis and urinalysis. For patient visits meeting inclusion criteria, we compared mean stone size and the rate of moderate-to-severe hydronephrosis found on imaging in patients with and without microscopic hematuria on urinalysis.ResultsOut of a total of 2,370 patient visits 393 (16.6%) met inclusion criteria. Of those, 321 (82%) had microscopic hematuria present on urinalysis. Patient visits without microscopic hematuria had a higher rate of moderate-to-severe hydronephrosis (42%), when compared to patients with microscopic hematuria present (25%, p=.005). Mean ureteral stone size among patient visits without microscopic hematuria was 5.7 mm; it was 4.7 mm for those patients with microscopic hematuria (p=.09). For ureteral stones 5 mm or larger, the incidence of moderate-to-severe hydronephrosis was 49%, whereas for ureteral calculi less than 5 mm in size, the incidence of moderate-to-severe hydronephrosis was 14% (p < 0.0001).ConclusionPatients visiting the ED with single-stone ureterolithiasis without microscopic hematuria on urinalysis could be at increased risk of having moderate-to-severe hydronephrosis compared to similar patients presenting with microscopic hematuria on urinalysis. Although the presence of hematuria on urinalysis is a moderately sensitive screening test for urolithiasis, these results suggest patients without hematuria tend to have more clinically significant ureteral calculi, making their detection more important. Clinicians should maintain a high index of suspicion for urolithiasis, even in the absence of hematuria, since ureteral stones in these patients were found to be associated with a higher incidence of obstructive uropathy.

show abstract

“…After reviewing the titles of the 76 articles, the physical therapist reviewed the abstracts of 18 articles and determined that the published clinical diagnostic strategies did not have sufficient sensitivity to rule out renal calculi, although risk factors were identified. 30 The presence of hematuria has a sensitivity of 84% 21 and urinalysis, which includes testing for other chemical abnormalities, has a sensitivity of 69%. The focus of the search shifted from clinical strategies to diagnostic imaging, as 2 of the 18 abstracts referred to computed tomography (CT) as the gold standard for the diagnosis of renal calculi.…”

Section: Clinical Scenario 3: Atypical Low Back Painmentioning

confidence: 99%

Integration of Critically Appraised Topics Into Evidence-Based Physical Therapist Practice

Crowell¹,

Tragord²,

Taylor³

et al. 2012

J Orthop Sports Phys Ther

View full text Add to dashboard Cite

Utility of hematuria testing in patients with suspected renal colic: correlation with unenhanced helical CT results

Cited by 69 publications

References 8 publications

Forget the blood, not the stone! Microhaematuria in acute urolithiasis and the role of early CT scanning

Forget the blood, not the stone! Microhaematuria in acute urolithiasis and the role of early CT scanning

A Comparison of Urolithiasis in the Presence and Absence of Microscopic Hematuria in the Emergency Department

Integration of Critically Appraised Topics Into Evidence-Based Physical Therapist Practice

Contact Info

Product

Resources

About