title: Unenhanced helical computed tomography in the evaluation of acute flank pain.
abstract: OBJECTIVE
  The diagnostic value of unenhanced helical computed tomography (CT) for the evaluation of acute flank pain is investigated in a prospective study.
  
  
  METHODS
  In 125 patients aged 18-86 years, we performed unenhanced helical CT in addition to abdominal plain film, abdominal ultrasound and urinalysis as a diagnostic measure for acute flank pain. Ureteral calculi were confirmed or, respectively, excluded by retrograde ureteropyelography in 80 cases. In the other cases, diagnosis was verified by clinical course and/or stone asservation.
  
  
  RESULTS
  In 91 of 125 patients the flank pain was caused by a ureteral calculus. In 67 of 91 patients with urolithiasis, stones could be collected for analysis. Helical CT was able to precisely identify 90 ureteral calculi. Abdominal plain films led to 8 false-positive and 48 false-negative findings. Thus, sensitivity of plain radiography, ultrasound and urinalysis was 47, 11 and 84% with a specificity 76, 97 and 32%, respectively.
  
  
  CONCLUSIONS
  Unenhanced helical CT reaches a distinctively increased diagnostic value (sensitivity 99%, specificity 97%) in the evaluation of acute flank pain as compared to plain radiography, ultrasound and urinalysis.
authors: Department of Urology, Klinikum Augsburg, Germany.
authors: M
authors: M
authors: Hamm
authors: F
authors: F
authors: Wawroschek
authors: D
authors: D
authors: Weckermann
authors: E
authors: E
authors: Knöpfle
authors: T
authors: T
authors: Häckel
authors: H
authors: H
authors: Häuser
authors: G
authors: G
authors: Krawczak
authors: R
authors: R
authors: Harzmann
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D021501:Flank Pain / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*