title: CT urograms in pediatric patients with ureteral calculi: do adult criteria work?
abstract: BACKGROUND
  Secondary signs of urinary obstruction associated with ureteral calculi are useful adjuncts to diagnosis in adults with renal colic evaluated by unenhanced helical CT.
  
  
  OBJECTIVE
  Our purpose was to evaluate the frequency of secondary signs of obstruction in children with renal colic undergoing unenhanced helical CT.
  
  
  METHODS
  Ureteral calculi were identified in 20 of 61 children with acute flank pain examined by unenhanced helical CT. Each imaging study was evaluated for the presence of secondary signs of urinary obstruction. The frequencies of individual signs were compared with each other by means of the McNemar test.
  
  
  RESULTS
  Six children had no secondary sign identified. In the remaining 14 children, proximal ureteral dilatation was seen in 10, renal enlargement in 10, hydronephrosis in 9, tissue rim sign in 6, decreased kidney attenuation in 5, and perinephric stranding in 1. Comparison of the frequencies strongly suggested that perinephric stranding occurs less frequently than proximal ureteral dilatation (P = 0.004), hydronephrosis (P = 0.008), or renal enlargement (P = 0.012).
  
  
  CONCLUSIONS
  Perinephric stranding, a common secondary sign in adults with ureteral calculi, occurs less frequently in children than other reported secondary signs.
authors.affiliation: Department of Radiology, St. Christopher's Hospital for Children, Erie Avenue at Front Street, Philadelphia, PA 19134, USA. eleanor.smergel@drexel.edu
authors.forename: E
authors.initials: E
authors.lastname: Smergel
authors.forename: S B
authors.initials: SB
authors.lastname: Greenberg
authors.forename: K L
authors.initials: KL
authors.lastname: Crisci
authors.forename: J K
authors.initials: JK
authors.lastname: Salwen
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D005260:Female; D021501:Flank Pain / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014514:Ureteral Calculi / Q000150:complications / Q000000981:diagnostic imaging*; D014517:Ureteral Obstruction / Q000150:complications / Q000000981:diagnostic imaging*