Accuracy of bladder stone detection using abdominal x-ray after spinal cord injury.
BACKGROUND
Bladder calculi are a common problem in those with spinal cord injury (SCI). Detection is important to prevent complications.


OBJECTIVE
To determine the accuracy of bladder stone detection by abdominal x-rays.


METHODS
X-ray reports from individuals with SCI with known bladder stones detected by cystoscopy were reviewed.


METHODS
X-ray reports noted the presence or absence of bladder stones. The stone variables evaluated were stone composition (crystallographic analysis), widest dimension of the largest stone (during cystoscopy), and the total volume (cm3) of the stone mass removed.


RESULTS
Sixty-two consecutive x-ray reports from individuals with bladder stones were reviewed. The majority of stones were calcium phosphate (46.8%) or struvite (26.7%). Regarding stone composition, the detection by x-ray was 28.6% for struvite stones and 41.9% for calcium phosphate stones. Regarding diameter of largest stone, the detection by x-ray was 14% for stones < 0.5 cm, 0% for stones 0.5 cm to 0.9 cm, 33% for stones 1.0 cm to 1.49 cm, 33% for stones 1.5 cm to 1.9 cm, and 54% for stones > or = 2.0 cm. Regarding total volume of stones, the detection by x-ray was 0% for volumes < 0.2 cm3, 33% for volumes 0.2 cm3 to 0.39 cm3, 60% for volumes 0.40 cm3 to 0.59 cm3, 40% for volumes of 0.60 cm3 to 0.79 cm3, 0% for stones from 0.8 cm3 to 0.99 cm3, and 57% for volumes > or = 1.0 cm3. Overall, 13/62 (20.97%) of stones found during cystoscopy were detected by the x-ray.


CONCLUSIONS
Abdominal x-ray is not a reliable method to detect bladder stones in individuals with SCI.
Linsenmeyer
Mark A
MA
Department of Urology, Kessler Institute for Rehabilitation, West Orange, New Jersey 07052, USA.
Linsenmeyer
Todd A
TA
D000328:Adult; D002129:Calcium Oxalate / Q000032:analysis; D002130:Calcium Phosphates / Q000032:analysis; D003558:Cystoscopy; D005260:Female; D006801:Humans; D017616:Magnesium Compounds / Q000032:analysis; D008297:Male; D010710:Phosphates / Q000032:analysis; D011859:Radiography; D012680:Sensitivity and Specificity; D013119:Spinal Cord Injuries / Q000150:complications* / Q000000981:diagnostic imaging; D000069877:Struvite; D014527:Uric Acid / Q000032:analysis; D001744:Urinary Bladder Calculi / Q000737:chemistry / Q000000981:diagnostic imaging*; D001750:Urinary Bladder, Neurogenic / Q000000981:diagnostic imaging
D002130:Calcium Phosphates; D017616:Magnesium Compounds; D010710:Phosphates; D002129:Calcium Oxalate; D014527:Uric Acid; C020243:calcium phosphate; D000069877:Struvite