CT for suspected kidney stones often uncovers other findings

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NEW YORK (Reuters Health), Jun 5 - Seventy-one percent of patients with acute flank pain and suspected urolithiasis have other or additional findings when evaluated with CT, according to a new report. While most of these findings are inconsequential, a minority do require treatment, possibly even immediate intervention.

The findings, which appear in the May issue of the Journal of Urology, are based on a study of 1,500 consecutive patients who were evaluated with unenhanced CT for acute flank pain.

Sixty-nine percent of the patients had urinary tract calculi, Dr. Harriet C. Thoeny and colleagues, from the University of Bern in Switzerland, note. Roughly a third each had nephrolithiasis, ureterolithiasis, or both. Only 32% of patients with stones had this as their sole CT finding.

Besides the 1,035 patients with confirmed stones, 360 had other CT findings without urolithiasis and 105 had normal findings.

Fourteen percent of all patients had a nonstone CT finding that required immediate or deferred treatment, the authors note. The most common finding mandating immediate treatment was pyelonephritis, while enlarged lymph nodes were the most common reason for deferred treatment.

CT findings of little or no clinical importance were noted 31% and 26% of patients, respectively, the authors state.

"Unenhanced CT in patients with acute flank pain is an excellent tool for the accurate diagnosis of urinary calculi. It also produces a wide spectrum of alternate or additional findings requiring emergency or deferred treatment in a substantial number of patients," the authors conclude.

Last Updated: 2006-06-02 15:15:15 -0400 (Reuters Health)

J Urol 2006;175:1725-1730.

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