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Nephrolithiasis ImagingAka: Ureteral Calculi Imaging, Kidney Stone Imaging

Indications
1. Suspected Nephrolithiasis
Noncontrast Helical CT Urogram (preferred, gold standard)
1. Indications
  1. All nonpregnant patients
2. Efficacy
  1. Sensitivity: 95 to 100%
  2. Specificity: 94 to 96%
  3. Preferred over intravenous pyelogram
    1. Worster (2002) Ann Emerg Med 40:280
3. Findings
  1. Renal morphology
  2. Ureteral stone localization
Abdominal ultrasound
1. Indications
  1. Pregnant patient
  2. Cholecystitis suspected
  3. Gynecologic process suspected
2. Efficacy
  1. Sensitivity: 19%
  2. Specificity: 97%
3. Findings
  1. Hydronephrosis
  2. Renal Stones
Abdominal XRay
1. Indications
  1. History of prior radiopaque stones
2. Efficacy
  1. Sensitivity: 45 to 59%
  2. Specificity: 71 to 77%
3. Findings
  1. Radiodense (radiopaque) stones
    1. Calcium Oxalate Stones
    2. Struvite Stones
  2. Intermediate stone lucency
    1. Cystine Stones
  3. Radiolucent stones (not visible on XRay)
    1. Uric Acid stones
Intravenous Pyelogram (IVP)
1. Indications
  1. Nonpregnant patients where CT is not available
2. Efficacy
  1. Sensitivity: 64 to 87%
  2. Specificity: 92 to 94%
3. Findings
  1. Functional renal and ureter study
References

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.