Jan 23, 2015
Use of CT scans for the evaluation of renal colic increased 10
1996 to 2007. Is this good for patients? Have they benefitted
from the detailed information that CT scanning? The answer is no.
Several studies have revealed that we are not only irradiatiting
patients at an increasingly alarming rate, their outcomes are not
improving because of it. In this episode, recorded at the Cabo CME
retreat, ERCast meets up with Matt Dawson and Mike Mallin
from The Ultrasound
Podcast to discuss the article Ultrasonography
versus computed tomography for suspected
- About 3ooo patients with suspected renal colic divided into 3
groups defined by initial diagnostic study
- CT scan
- Radiology Ultrasound
- Point of Care Ultrasound
- Results: Using CT as the initial study increased radiation
exposure but did not reduce adverse outcomes.
- ERCast editorial: Another way to look at: Starting with
ultrasound as the initial imaging modality decreased radiation
exposure and did not increase adverse outcomes. Whether you see the
cup as half full or half empty, starting with US in an
uncomplicated case of suspected renal colic seems like the right
call. If you start with CT on everybody, then everybody gets
For a more detailed discussion on this topic, check out
Rebecca, et al. "Ultrasonography versus computed tomography for
suspected nephrolithiasis." New England Journal of
Medicine371.12 (2014): 1100-1110.
Westphalen, Antonio C., et al. "Radiological imaging of patients
with suspected urinary tract stones: national trends, diagnoses,
and predictors." Academic Emergency
Medicine 18.7 (2011): 699-707.
Moore, Christopher L., and Leslie Scoutt. "Sonography first for
acute flank pain?." Journal of Ultrasound in
Medicine 31.11 (2012): 1703-1711.