IMAGING IN ACUTE RENAL COLIC - THE INTRAVENOUS UROGRAM REMAINS THE GOLD STANDARD

In a prospective study of 150 consecutive patients presenting over a 1 -year period with acute renal colic, we compared the accurracy of intr avenous urogram (IVU) and ultrasound (US) in identifying and localizin g ureteric calculi and hydronephrosis. IVU was far superior to US. It identified 141 ureteric calculi vs. only one by US (P < 0.00001) and 1 09 hydronephroses vs. 66 (P < 0.0001). It is concluded that IVU remain s the gold standard for imaging in acute renal colic. US +/- plain sup ine abdominal film should be reserved for contrast medium risk patient s and those in whom radiation is relatively contraindicated.