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I am not sure if this is the first option (doing KUB)

When you come across a pt w/ renal colic you have no idea what's causing this (could be stone ±radiopaque, abscess, cancer, trauma). Also, you don't know if this pt has obstruction (urinalysis and BUN/Cr won't help you if only 1 ureter is obstructed).

KUB: Will show if there is a stone or not. End of discussion.

U/S: Might show stone, but also will assess if there is dilation, scars, masses, perinephric or nephric pathology.

Thus I'd go for Ultrasound as a first evaluation, tied with UA, and bloodwork
 

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Discussion Starter · #4 ·
Update

USMLEWORLD info I've recently come across mentions that the best initial modality is neither KUB nor US, but non-contrast spiral CT. The explanation writer argues that KUB can miss radiolucent stones (15% of stones) and small stones. US can also miss small stones, although it would be the only modality that's safe to order in pregnant patients.
 

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USMLEWORLD info I've recently come across mentions that the best initial modality is neither KUB nor US, but non-contrast spiral CT. The explanation writer argues that KUB can miss radiolucent stones (15% of stones) and small stones. US can also miss small stones, although it would be the only modality that's safe to order in pregnant patients.
Are you sure that CT is not the most specific? I doubt that we should do a CT in all of our pts w/ a renal colic...
 

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Discussion Starter · #6 ·
Are you sure that CT is not the most specific? I doubt that we should do a CT in all of our pts w/ a renal colic...
Here's the exact terms used: the question asked for the best test to diagnose the condition. In the explanation, it's mentioned that it's the first-line modality and is quick to perform. In the educational objective, it said it's the imaging modality of choice for diagnosis.

The question ID is 2298.
 

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Here's the exact terms used: the question asked for the best test to diagnose the condition. In the explanation, it's mentioned that it's the first-line modality and is quick to perform. In the educational objective, it said it's the imaging modality of choice for diagnosis.

The question ID is 2298.
I will definitely check it out. Thanks Haisook!
 

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renal stone

Well...CT means radiation.....
renal stone can be diagnosed by history and PE + inv

summer, colic like pain radiating loin to groin
no fever

KUB is the most quick inv u can do.
If u want specific, usg because even rediolucent calculi will be seen

I would say KUB

Can anyone check that for sure please
 

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What is the initial test of choice in suspected renal colic
Is it KUB or Ultrasound? :notsure:
CT scan without contrast is the BEST choice to make an accurate diagnosis , the stone is visible 100% , disadvantage (radiation, can't be done in case of pregnancy)

ultrasound is a good choice, but limited in case of small stone or gas (higher in renal colic)

KUB is a good choice but causes radiations and also very limited unless the stone is big and opaque

in my opinion first episode of renal colic : CT scan without contrast best for DC accuracy

but the first line in case of any abdominal pain is KUB anyway
 

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definitely not USG.... it doesnt detect stones... just looks at the hydronephrosis or the dilated calyceal system....

according to me after reading goljan patho its gotta be CT scan...
USG does detect stones, the limit is when the stones are in the ureters or if there is a lot of gas........... it's definitely the exam to do if yo have a pregnant women with renal colic for example
 
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