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. 2022 Aug;22(3):351-356.
doi: 10.18295/squmj.9.2021.130. Epub 2022 Aug 25.

The Accuracy of Point-of-Care Ultrasound Performed by Emergency Physicians in Detecting Hydronephrosis in Patients with Renal Colic

Abdulaziz Al-Balushi  1 , Amal Al-Shibli  2 , Abdullah Al-Reesi  2 , Qazi Zia Ullah  2 , Waleed Al-Shukaili  2 , Saleh Baawain  3 , Hamoud Al-Dhuhli  3 , Mohammed Al-Shamsi  4 , Ahmed Al-Hubaishi  5 , Al Yaqdhan H Al-Atbi  6
Affiliations

The Accuracy of Point-of-Care Ultrasound Performed by Emergency Physicians in Detecting Hydronephrosis in Patients with Renal Colic

Abdulaziz Al-Balushi et al. Sultan Qaboos Univ Med J. 2022 Aug.

Abstract

Objectives: This study aimed to determine the accuracy of renal point-of-care ultrasound (POCUS) performed by emergency physicians in detecting hydronephrosis in patients with renal colic.

Methods: This prospective cross-sectional diagnostic study was conducted at the Emergency Department (ED) of Sultan Qaboos University Hospital from February 2017 to February 2018. All adult patients with suspected renal colic and who could give informed consent were included. The emergency physicians performed POCUS on both kidneys and graded hydronephrosis as none, mild, moderate or severe. The POCUS grade was compared to the non-contrast computed tomography (NCCT) grade.

Results: A total of 303 participants were enrolled in the analysis. The majority of the study population comprised adult males (247 [81.5%]), and the mean age was 39 years. Among the samples, 71.3% of the patients exhibited a degree of hydronephrosis based on CT findings. Ultrasounds performed by emergency physicians had a sensitivity of 75.8% (95% CI: 69.5-81.4), specificity of 55.2% (95% CI: 44.1-65.8), a positive likelihood ratio of 1.69 (95% CI: 1.32-2.16) and a negative likelihood ratio of 0.43 (95% CI: 0.32-0.59) for hydronephrosis using CT as the criterion standard.

Conclusion: When evaluating patients with suspected renal colic, a bedside renal POCUS performed by emergency physicians has a moderate sensitivity to detect hydronephrosis and grade its severity. Therefore, it should be utilised in the ED to screen patients for hydronephrosis; however, more training is required to improve the test's accuracy.

Keywords: Hematuria; Hydronephrosis; Nephrolithiasis; Oman; Point-of-Care Testing; Renal Colic; Ultrasonography.

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Conflict of interest statement

CONFLICT OF INTEREST The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Grading hydronephrosis severity using point-of-care ultrasound as (A) mild, (B) moderate and (C) severe.
Figure 2
Figure 2
Flowchart of study procedure. POCUS = point-of-care ultrasound; CT= computed tomography; ED = emergency department.
Figure 3
Figure 3
A diagram of test characteristics of any hydronephrosis on ultrasonography compared with any hydronephrosis on CT. POCUS = point-of-care ultrasound; NCCT = non-contrast computed tomography.
See this image and copyright information in PMC

References

    1. Teichman JMH. Clinical practice. Acute renal colic from ureteral calculus. N Engl J Med. 2004;350:684–93. doi: 10.1056/NEJMcp030813. - DOI - PubMed
    1. Feit L, John D, Delgado Torres N, Sinert R. Flank pain and hematuria is not always a kidney stone. Am J Emerg Med. 2021;40:225e1–2. doi: 10.1016/j.ajem.2020.07.046. - DOI - PubMed
    1. Schoenfeld EM, Shieh M-S, Pekow PS, Scales CD, Munger JM, Lindenauer PK. Association of patient and visit characteristics with rate and timing of urologic procedures for patients discharged from the emergency department with renal colic. JAMA Netw Open. 2019;2:e1916454. doi: 10.1001/jamanetworkopen.2019.16454. - DOI - PMC - PubMed
    1. Daniels B, Gross CP, Molinaro A, Singh D, Luty S, Jessey R, et al. STONE PLUS: Evaluation of emergency department patients with suspected renal colic, using a clinical prediction tool combined with point-of-care limited ultrasonography. Ann Emerg Med. 2016;67:439–48. doi: 10.1016/j.annemergmed.2015.10.020. - DOI - PMC - PubMed
    1. ClinicalKey. Nephrolithiasis. [Accessed: Jul 2021]. From: https://www.clinicalkey.com/#!/content/book/3-s2.0-B9781455753598000080.

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