Can Emergency Physicians Detect Hydronephrosis with Bedside Ultrasound?

Definitive diagnosis of acute nephrolithiasis often requires computed tomography (CT). To avoid ionizing radiation, recent studies have evaluated clinical decision rules combined with ultrasound as an alternative to CT scan. But is it safe to rely on ultrasound to diagnose renal colic? Investigators compared the accuracy of renal ultrasound scans performed by emergency clinicians with that of later CT scans in patients with suspected renal colic.

The sample included 670 ultrasounds provided by 144 clinicians from a single academic emergency department. Overall, both sensitivity and specificity of ultrasound for hydronephrosis were 73%. The values were 93% and 81%, respectively, for attending physicians with ultrasound fellowship training.