title: Imaging protocol for suspected ureteric calculi in patients presenting to the emergency department.
abstract: OBJECTIVE
  To ensure diagnostic yields were adequate in patients with suspected ureteric calculi with and without haematuria, and to assess whether there was a significant difference between these two groups in men and women.
  
  
  METHODS
  A retrospective analysis was undertaken of 513 patient records who attended the Emergency Department with suspected ureteric colic over 8 months.
  
  
  RESULTS
  513 patient records were evaluated. The overall positive rate for calculi was 45.4%, with an alternative diagnosis in 14.4%. Of the patients scanned with haematuria 49.36% were positive. The positive scan rate in males was significantly higher than in females (56% v. 31%, p < 0.0001). 32.79% of patients scanned without haematuria had a proven calculus. The positive rate in males without haematuria was 40.39% versus 27.14% in females.
  
  
  CONCLUSIONS
  The overall diagnostic yield of 45.4% is acceptable according to national guidelines. A large number of patients scanned without haematuria were found to have a calculus. This review suggests that in males a negative urine dipstick should not preclude CT investigation for renal colic in the presence of a "classical" history. However, the number of female patients with negative scans suggests that further randomized studies are needed to identify the ideal investigation pathway in women.
authors.affiliation: Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK.
authors.forename: T C
authors.initials: TC
authors.lastname: Hall
authors.affiliation: Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK. Electronic address: jastephenson@doctors.org.uk.
authors.forename: J A
authors.initials: JA
authors.lastname: Stephenson
authors.affiliation: Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK.
authors.forename: A
authors.initials: A
authors.lastname: Rangaraj
authors.affiliation: Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK.
authors.forename: K
authors.initials: K
authors.lastname: Mulcahy
authors.affiliation: Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK.
authors.forename: A
authors.initials: A
authors.lastname: Rajesh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006417:Hematuria / Q000150:complications / Q000175:diagnosis / Q000652:urine*; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000706:statistics & numerical data; D006113:United Kingdom; D014513:Ureter / Q000000981:diagnostic imaging; D014514:Ureteral Calculi / Q000150:complications / Q000000981:diagnostic imaging* / Q000652:urine*; D055815:Young Adult