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. 2021 Nov 22;13(1):45.
doi: 10.1186/s13089-021-00246-2.

Ultrasound at the patient's bedside for the diagnosis and prognostication of a renal colic

Jean-Eudes Bourcier  1   2 , Emeric Gallard  3 , Jean-Philippe Redonnet  3 , Morgan Abillard  3 , Quentin Billaut  3 , Laura Fauque  3 , Anna Jouanolou  3 , Didier Garnier  3
Affiliations

Ultrasound at the patient's bedside for the diagnosis and prognostication of a renal colic

Jean-Eudes Bourcier et al. Ultrasound J. .

Abstract

Background: Diagnosing a ureteral colic is sometimes difficult; however, clinicians should not fail to detect a surgical emergency. This is why diagnostic strategies depend on the imaging examinations, especially ultrasound. Prior studies have investigated the accuracy of Point of Care Ultrasound (PoCUS), but there are relatively few. This study aimed to evaluate the performance of the PoCUS in the diagnosis of renal colic. The secondary objective was to evaluate the relationship between the imaging results and the treatment performed.

Methods: After the clinical evaluation of patients aged > 18 years with suspected ureteral colic, the Emergency Physician (EP) trained in ultrasound performed PoCUS to conclude whether a diagnosis of "renal colic" should be made. A computed tomography (CT) examination was subsequently performed, to determine whether ureteral or bladder lithiasis was present to diagnose a ureteral colic. The patient's management was decided according to the to degree of urinary tract dilatation, presence of perinephric fluid, size, and localization of stones.

Results: Of the 12 Eps in our units, seven met the training criteria for the inclusion of patients. A total of 103 patients were analyzed, and the renal colic diagnosis was retained in 85 cases after the CT examination. The accuracy of PoCUS was 91% (86; 95%) for detecting urinary tract dilatation, 83% (76; 90%) for detecting perinephric fluid, and 54% (44; 64%) for detecting lithiasis. Only high urinary tract stones with ≥ 6 mm diameter were surgically managed (p < 0.01). Conversely, distal ureteral stones with a diameter of < 6 mm were managed with medical ambulatory treatment (p < 0.05).

Conclusion: PoCUS is a good diagnostic tool, for renal colic, and could help reduce the requirement for the CT examinations and, hence, reduce induced radiation exposure.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Successive probe positions to explore urinary tract
Fig. 2
Fig. 2
Ultrasound images: a pyelocalyceal dilatation and proximal lithiasis, b pyelocalyceal dilatation, c perinephric fluid, d pelvic lithiasis, e bladder lithiasis and twinkle artifact in color doppler; and f bladder lithiasis
Fig. 3
Fig. 3
Patient flowchart
Fig. 4
Fig. 4
Use of imaging (PoCUS and CT) for the management of patients presenting with ureteral colic
See this image and copyright information in PMC

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