The Use of Computed Tomography for Diagnosing Nephrolithiasis in Emergency Departments

Abstract Background: Flank pain due to nephrolithiasis is one of the cardinal emergency department (ED) presentations. It may lead to impaired renal functions and other complications. Occasionally, urgent therapeutic intervention is mandatory. Computed tomography of kidneys, ureters, and bladder (CT-KUB) on such patients is usually the standard of care to diagnose renal colic, as it is a rapid and contrast-free imaging. However, exposure to radiological imaging can lead to ionizing radiation complications. Objectives: To investigate the rate of negative CT-KUB ordered in the ED for people presenting with flank pain to diagnose nephrolithiasis. Additionally, we aimed to examine the gender differences in these studies. Materials and Methods: A retrospective single academic center chart review study was conducted over one year. We included all adult patients with complaints of flank pain and received CT-KUB to diagnose nephrolithiasis. Results: A total of 283 patients received CT-KUB. Of them, 170 (60.08%) were males and 113 (39.92%) were females. Females had a significantly lower rate of nephrolithiasis (25.7%) ( P < 0.001) and hydronephrosis 13.3% ( P < 0.001) in comparison with males (44.7% and 34.7%, respectively). Conclusion: An alternative modality for investigation should be set to exclude nephrolithiasis in young females, with the benefit of non-exposure to unnecessary radiation in the ED.