Ultrasonic diagnosis of ureteral calculi in patients with acute flank pain.

The diagnostic value of ultrasonography (US) and intravenous urography has been compared in a prospective study comprising 123 consecutive patients with severe acute flank pain of less than 72 hours' duration. Ultrasonography was performed transabdominally with a 5 MHz sector real-time transducer. Ureteral calculi were considered the final diagnoses in 46 patients, of which 35 with and 11 without accompanying hydronephrosis. Ureteral calculi were correctly diagnosed by US in 17 patients (sensitivity 37%). If hydronephrosis with or without calculus is included as a positive sign of ureteral calculus, a correct diagnosis was suggested by US in 34 patients (sensitivity 74%). We consider US to be a valuable method in patients with previous contrast media reactions, but recommend urography as the standard imaging method when renal colic is clinically suspected.