Table 1.

Imaging methods for suspected kidney stones recommended by a panel of experts: Rows that suggest 2 imaging methods indicate cases of only moderate agreement among panel members. Most clinical vignettes were done with male patients and noted minimal difference between sexes but stated “it may be more reasonable to forego CT in a female than a male patient (slightly more risk of radiation and somewhat higher likelihood of finding an alternative diagnosis in the pelvis/adnexa) with ultrasound.”13

POPULATIONCLINICAL PRESENTATIONNO IMAGINGPOCUSRPUSRDCT
Young adults (age about 35 y)History of kidney stones and typical presentation✓✓*
No history of kidney stones and typical presentation✓*✓†
History of kidney stones and atypical presentation✓‡✓
No history of kidney stones and atypical presentation✓
Pregnant or pediatricNo history of kidney stones and typical presentation✓*
Middle-aged adults (age about 55 y)History of kidney stones and typical presentation✓✓
No history of kidney stones or atypical presentation✓
Older adults (age about 75 y)All clinical presentations✓
Any adultInadequate pain relief✓

  • CT—computed tomography, POCUS—point-of-care ultrasound, RDCT—reduced-radiation-dose computed tomography, RPUS—radiology-performed ultrasound.

  • ↵* No follow-up imaging regardless of presence or absence of hydronephrosis.

  • ↵† Consider POCUS or RPUS in female patients.

  • ↵‡ Consider RDCT if hydronephrosis is absent.

  • Data from Moore et al.13