title: Has the significance of incidental findings on unenhanced computed tomography for urolithiasis been overestimated? A retrospective review of over 800 patients.
abstract: OBJECTIVE
  To evaluate the detection of clinically unsuspected pathologies using 64-slice multidetector computed tomography (CT) of the abdomen in patients with flank pain. The presence of significant incidental findings (those warranting immediate management) was also correlated with that of urolithiasis, to assess potential changes of management.
  
  
  METHODS
  The study included 899 patients undergoing CT in a 6-month period between June and December 2008. Patients who were referred from outside, with no medical record in the hospital where the study was conducted, and those who were lost to follow-up, were excluded. All of the CT examinations were reported after a radiology resident and a consultant radiologist with >4 years of experience evaluated the CT. Genitourinary and extra-genitourinary findings were assessed and divided into clinically significant or not.
  
  
  RESULTS
  The overall incidence of additional and incidental findings was 14%. Besides urolithiasis and obstruction there were 34 (28%) genitourinary findings and 87 (72%) extra-genitourinary findings; most of the former were insignificant. Of the extra-genitourinary findings, significant diagnoses were documented in 34 cases.
  
  
  CONCLUSIONS
  Abdominal multidetector CT detects more incidental findings which are clinically significant.
authors.affiliation: Department of Radiology, Aga Khan University, Karachi, Pakistan.
authors.forename: Nadir
authors.initials: N
authors.lastname: Khan
authors.affiliation: Department of Surgery, Aga Khan University, Karachi, Pakistan.
authors.forename: M Hammad
authors.initials: MH
authors.lastname: Ather
authors.affiliation: Department of Radiology, Aga Khan University, Karachi, Pakistan.
authors.forename: Farhan
authors.initials: F
authors.lastname: Ahmed
authors.affiliation: Research Associate in Diagnostic Imaging, Rhode Island Hospital/Brown University, Providence, RI, USA.
authors.forename: Abdul M
authors.initials: AM
authors.lastname: Zafar
authors.affiliation: Department of Radiology, Aga Khan University, Karachi, Pakistan.
authors.forename: Aamir
authors.initials: A
authors.lastname: Khan
keywords: CT; Clinical significance; GU, genitourinary; Genitourinary; Incidental cancer; Incidental findings; KUB, kidneys, ureters and bladder; MD, multidetector