Diagnostic test for renal stones

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Diagnostic test for renal stones

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nida
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07/16/06 - 01:54 PM

Harrison's Q

A 34-year-old male presents with acute onset of right flank pain radiating to the groin. He is not febrile but appears to be very uncomfortable. He is writhing in his bed. The physical examination is otherwise unremarkable. Urinalysis shows 25 to 35 red blood cells per high-power field. Which of the following is the diagnostic test of choice?
A. Noncontrast helical computed tomography (CT)
B. Contrast-enhanced computed tomography
C. Intravenous pyelography
D. Plain radiograms of the abdomen and pelvis
E. Ultrasound

msyamp
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07/16/06 - 02:17 PM

CT A

Edited by msyamp on 07/17/06 - 11:57 AM

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cyra
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07/16/06 - 02:50 PM

Venturing a (semi) educated guess here...A

drk1980
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07/16/06 - 03:02 PM

With contrast wud show well a space filling defect in the location of a stone.

som
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07/16/06 - 07:49 PM

h/o suggests a renal colic..i pick KUB

docofthebigapple
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07/16/06 - 09:27 PM

MY pick A. Non contrast CT. Remember this one is Helical. sensitive enough.

MAZI
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07/17/06 - 09:38 AM

i agree with A

nida
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07/18/06 - 03:51 PM

The answer is A.

For many years intravenous pyelography was the diagnostic procedure of choice for the diagnosis of a renal stone. In recent years it has been replaced by helical CT scan without intravenous contrast. Administration of radiodense intravenous contrast that is excreted in the urine may obscure ureteral stones. The advantages of this diagnostic tool include lack of exposure to contrast dye, ability to visualize uric acid stones, and possible visualization of other causes of abdominal pain. Plain radiograms and ultrasound are not sensitive for the detection of nephrolithiasis.

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