ACR appropriateness criteria® acute onset flank pain-suspicion of stone disease

Courtney A. Coursey, David D. Casalino, Erick M. Remer, Ronald S. Arellano, Jay T. Bishoff, Manjiri Dighe, Pat Fulgham, Stanley Goldfarb, Gary M. Israel, Elizabeth Lazarus, John R. Leyendecker, Massoud Majd, Paul Nikolaidis, Nicholas Papanicolaou, Srinivasa Prasad, Parvati Ramchandani, Sheila Sheth, Raghunandan Vikram

Research output: Contribution to journalReview article

81 Citations (Scopus)

Abstract

Low dose (<3 mSv) noncontrast CT (NCCT) is the imaging study of choice for accurate evaluation of patients with acute onset of flank pain and suspicion of stone disease (sensitivity 97%, specificity 95%). NCCT can reliably characterize the location and size of an offending ureteral calculus, identify complications, and diagnose alternative etiologies of abdominal pain such as appendicitis. By comparison, the sensitivity of radiographs (59%) and ultrasound (24-57%) for the detection of renal and ureteral calculi is relatively poor. Ultrasound can accurately diagnose pelvicaliectasis and ureterectasis, but it may take several hours for these findings to develop. In the pregnant patient, however, ultrasound is a first line test as it does not expose the fetus to ionizing radiation. MR is an accurate test for the diagnosis of pelvicaliectasis and ureterectasis, but is less sensitive than CT for the diagnosis of renal and ureteral calculi. For patients with known stone disease whose stones are visible on radiographs, radiographs are a good tool for post-treatment follow-up.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)227-233
Number of pages7
JournalUltrasound Quarterly
Volume28
Issue number3
DOIs
StatePublished - Sep 1 2012

Fingerprint

Flank Pain
Ureteral Calculi
Kidney Calculi
Guidelines
Expert Testimony
Appendicitis
Ionizing Radiation
Radiology
Abdominal Pain
Fetus
Therapeutics
Sensitivity and Specificity

Keywords

  • Appropriateness Criteria
  • comparative studies
  • computed tomography
  • nephroureterolithiasis
  • ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Coursey, C. A., Casalino, D. D., Remer, E. M., Arellano, R. S., Bishoff, J. T., Dighe, M., ... Vikram, R. (2012). ACR appropriateness criteria® acute onset flank pain-suspicion of stone disease. Ultrasound Quarterly, 28(3), 227-233. https://doi.org/10.1097/RUQ.0b013e3182625974

ACR appropriateness criteria® acute onset flank pain-suspicion of stone disease. / Coursey, Courtney A.; Casalino, David D.; Remer, Erick M.; Arellano, Ronald S.; Bishoff, Jay T.; Dighe, Manjiri; Fulgham, Pat; Goldfarb, Stanley; Israel, Gary M.; Lazarus, Elizabeth; Leyendecker, John R.; Majd, Massoud; Nikolaidis, Paul; Papanicolaou, Nicholas; Prasad, Srinivasa; Ramchandani, Parvati; Sheth, Sheila; Vikram, Raghunandan.

In: Ultrasound Quarterly, Vol. 28, No. 3, 01.09.2012, p. 227-233.

Research output: Contribution to journalReview article

Coursey, CA, Casalino, DD, Remer, EM, Arellano, RS, Bishoff, JT, Dighe, M, Fulgham, P, Goldfarb, S, Israel, GM, Lazarus, E, Leyendecker, JR, Majd, M, Nikolaidis, P, Papanicolaou, N, Prasad, S, Ramchandani, P, Sheth, S & Vikram, R 2012, 'ACR appropriateness criteria® acute onset flank pain-suspicion of stone disease', Ultrasound Quarterly, vol. 28, no. 3, pp. 227-233. https://doi.org/10.1097/RUQ.0b013e3182625974
Coursey CA, Casalino DD, Remer EM, Arellano RS, Bishoff JT, Dighe M et al. ACR appropriateness criteria® acute onset flank pain-suspicion of stone disease. Ultrasound Quarterly. 2012 Sep 1;28(3):227-233. https://doi.org/10.1097/RUQ.0b013e3182625974
Coursey, Courtney A. ; Casalino, David D. ; Remer, Erick M. ; Arellano, Ronald S. ; Bishoff, Jay T. ; Dighe, Manjiri ; Fulgham, Pat ; Goldfarb, Stanley ; Israel, Gary M. ; Lazarus, Elizabeth ; Leyendecker, John R. ; Majd, Massoud ; Nikolaidis, Paul ; Papanicolaou, Nicholas ; Prasad, Srinivasa ; Ramchandani, Parvati ; Sheth, Sheila ; Vikram, Raghunandan. / ACR appropriateness criteria® acute onset flank pain-suspicion of stone disease. In: Ultrasound Quarterly. 2012 ; Vol. 28, No. 3. pp. 227-233.
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