Urolithiasis, CT and lithotripsy guidelines

3% of the population experiences a flank pain during its lifetime. A flank pain is explained by calculus disease in more than 70% of the cases. Since the introduction of spiral CT and lithotripsy the work up of urolithiasis h as changed. Many tests and treatment are available. KUB, IVP, ultrasound wi th color Doppler, CT and MR urography for diagnosis; lithotripsy, stenting or open surgery for treatment. The emergency practitioner, the radiologist and the urologist should answer three questions that will be reviewed in th is paper: Is the acute flank pain caused by urolithiasis? Will calculus be spontaneously discharged? Is lithotripsy indicated?