Excessive Use of CT as Initial Imaging for Kidney Stones

Although significant regional variation was observed, nearly two thirds of children underwent computed tomography as the first imaging study.

Recent guidelines recommend ultrasonography instead of computed tomography (CT) scans as the initial imaging study for diagnosis of pediatric and adolescent urinary stones. To estimate the prevalence of initial use of CT scan in this setting, researchers conducted a cross-sectional study of U.S. commercial health insurance claims data for 17,827,229 children insured between 2003 and 2011. Results were as follows:

Of 9642 children identified with a kidney stone episode, 9228 had imaging studies.
Overall, 63% of children had a CT exam as the first diagnostic study, and 24% had ultrasonography first.
Initial use of CT varied by state (range, 41%–79%).
Children living in Alabama, Kentucky, Mississippi, and Tennessee had the highest odds of receivin…

Reviewing Author

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

Excessive Use of CT as Initial Imaging for Kidney Stones

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Reviewing Author