title: Ultrasonography by emergency physicians in patients with suspected ureteral colic.
abstract: We performed a prospective study of patients with suspected ureteral colic to evaluate the test characteristics of bedside renal ultrasonography (US) performed by emergency physicians (EPs) for detecting hydronephrosis, and to evaluate how US can be used to predict the likelihood of nephrolithiasis. Thirteen EPs performed US, recorded the presence of hydronephrosis, and made an assessment of the likelihood of nephrolithiasis. All patients underwent i.v. pyelography (IVP) or unenhanced helical computed tomography (CT). There were 126 patients in the study: 84 underwent IVP; 42 underwent helical CT. Test characteristics of bedside US for detecting hydronephrosis were: sensitivity 72%, specificity 73%, positive predictive value (PPV) 85%, negative predictive value (NPV) 54%, accuracy 72%. The PPV and NPV for the ability of the EP to predict nephrolithiasis after performing US were 86% and 75%, respectively. We conclude that bedside US performed by EPs may be used to detect hydronephrosis and help predict the presence of nephrolithiasis.
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Rosen
authors.forename: D F
authors.initials: DF
authors.lastname: Brown
authors.forename: M J
authors.initials: MJ
authors.lastname: Sagarin
authors.forename: Y
authors.initials: Y
authors.lastname: Chang
authors.forename: C J
authors.initials: CJ
authors.lastname: McCabe
authors.forename: R E
authors.initials: RE
authors.lastname: Wolfe
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000150:complications / Q000000981:diagnostic imaging*; D015994:Incidence; D007669:Kidney Calculi / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology; D014567:Urography