Young Patients with Suspected Uncomplicated Renal Colic are Unlikely to Have Dangerous Alternative Diagnoses or Need Emergent Intervention
[Article]
Schoenfeld, Elizabeth M.; Poronsky, Kye E.; Elia, Tala R.; Budhram, Gavin R.; Garb, Jane L.; Mader, Timothy J.
Introduction: In the United States there is debate regarding the appropriate first test for new-onsetrenal colic, with non-contrast helical computed tomography (CT) receiving the highest ratings fromboth Agency for Healthcare Research and Quality and the American Urological Association. This isbased not only on its accuracy for the diagnosis of renal colic, but also its ability to diagnose othersurgical emergencies, which have been thought to occur in 10-15% of patients with suspected renalcolic, based on previous studies. In younger patients, it may be reasonable to attempt to avoidimmediate CT if concern for dangerous alternative diagnosis is low, based on the risks of radiationfrom CTs, and particularly in light of evidence that patients with renal colic have a very high likelihoodof having multiple CTs in their lifetimes. The objective is to determine the proportion of patients witha dangerous alternative diagnosis in adult patients age 50 and under presenting with uncomplicated(non-infected) suspected renal colic, and also to determine what proportion of these patientsundergo emergent urologic intervention.
2015
Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
16/2
Schoenfeld, Elizabeth M.; Poronsky, Kye E.; Elia, Tala R.; Budhram, Gavin R.; Garb, Jane L.; Mader, Timothy J.