Does Everyone with Renal Colic Need a CT Scan?

There is concern about excessive radiation related to routine computed tomography scanning for patients with suspected ureteral colic. Researchers retrospectively derived and prospectively validated a clinical prediction rule for uncomplicated ureteral stones in adults with flank pain. Patients with infection, trauma, known malignancy, renal disease, or prior urologic procedures were excluded.

The derivation cohort comprised 1040 adult patients with flank pain undergoing CT without contrast in the emergency department; the validation cohort comprised 491 such patients. Using multivariate logistic regression, the top five factors associated with ureteral stones — male sex, short pain duration, non-black race, nausea or vomiting, and microscop…