Point-of-care ultrasound (POCUS) has moderate accuracy for urolithiasis diagnosis, according to a new systematic review. While it’s not necessarily the best option for diagnosis, it can be a useful tool for imaging symptomatic emergency department patients. Ultrasound allows faster imaging than computed tomography (CT) without ionizing radiation and likely costs less.
“Given equivalent outcomes in the prevailing literature, it would be reasonable to use POCUS as a first line of imaging in the evaluation of patients with suspected urolithiasis,” Samuel Lam, MD, MPH, of the University of California, San Diego, and collaborators wrote in the Journal of Emergency Medicine.
In the review of 8 prospective and 2 retrospective studies (including 1 randomized controlled trial), the investigators found that POCUS displayed moderate sensitivity and specificity in diagnosing kidney stones compared with intravenous pyelography and/or CT, for example. Complication rates including death, missed serious diagnosis, and hospitalization were comparable for ultrasound and CT, used for initial imaging.
“Certain urinalysis and POCUS findings may improve POCUS tests characteristics, such as the presence of hematuria and degree of hydronephrosis,” Dr Lam and colleagues noted.
Mills L, Morley EJ, Soucy Z, et al. Ultrasound for the diagnosis and management of suspected urolithiasis in the emergency department. J Emerg Med.