Initial imaging choice in suspected renal colic
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u first start with KUB
if no Dx can be established based on KUB
then u go for ultrasound
if no Dx can be established based on KUB
then u go for ultrasound
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
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
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.
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...
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!
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
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
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
no it doesn't require bladder preparation or no solid food
ultrasound require that but not in case of emergency like a renal colic
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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