Acute flank pain: comparison of unenhanced helical CT and ultrasonography in detecting causes other than ureteroli
Catalano O, Nunziata A, Sandomenico F, Siani AEmerg Radiol. 2002 Sep;9(3):146-54. Epub 2002 May 4..
Department of Radiology, S. Maria delle Grazie Hospital, Via Domitiana Localita La Schiana, Pozzuoli, Italy. Orlandcat@tin.it
Several conditions can clinically mimic renal colic. We assessed the accuracy of non-contrast-enhanced helical CT and of ultrasonography (US) in offering an alternative explanation for flank pain. In a 3-year period, 181 patients with acute flank pain underwent US and non-contrast-enhanced helical CT in a blinded sequence. Their efficacy in detecting both alternative causes of pain and additional findings unrelated to the pain was assessed in 160 cases with a confirmed diagnosis. An alternative cause was found in 23 cases (14%). US gave 4 false-negative results (1 acute appendicitis, 1 ovarian cyst torsion, 1 diverticulitis, and 1 papillary necrosis) and 2 false-positive results (1 acute pyelonephritis and 1 diverticulitis), with a 78% sensitivity and a 98% specificity for nonlithiasic causes. CT gave 5 false-negative results (1 complicated ovarian cyst, 1 pleuritis, 1 epididymitis, 1 acute pyelonephritis, and 1 papillary necrosis) and 1 false-positive (1 simple ovarian cyst described as a complicated lesion), resulting in a 74% sensitivity and a 99% specificity for diagnosing alternative causes. There were 130 additional US findings in 68 patients and 151 additional CT findings in 77 patients. A wide spectrum of findings can be identified in subjects imaged for flank pain. Non-contrast-enhanced helical CT and US have comparable accuracy in diagnosing causes other than stone disease.
This abstract is being posted for educational purposes, as well as for comment and criticism, by the visitors to the Epididymitis Foundation website (www.EpididymitisFoundation.org ). This abstract is representative of a larger article that is indexed on Medline.
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