Mimics of renal colic: Alternative diagnoses at unenhanced helical CT

Creed M. Rucker, Christine O. Menias, Sanjeev Bhalla

Research output: Contribution to journalArticlepeer-review

84 Scopus citations

Abstract

During the past decade, unenhanced computed tomography (CT) has become the standard of reference in the detection of urinary calculi owing to its high sensitivity (>95%) and specificity (>98%) in this setting. Numerous diseases may manifest as acute flank pain and mimic urolithiasis. Up to one-third of unenhanced CT examinations performed because of flank pain may reveal unsuspected findings unrelated to stone disease, many of which can help explain the patient's condition. Alternative diagnoses are most commonly related to gynecologic conditions (especially adnexal masses) and nonstone genitourinary disease (eg, pyelonephritis, renal neoplasm), closely followed by gastrointestinal disease (especially appendicitis and diverticulitis). Hepatobiliary, vascular, and musculoskeletal conditions may also be encountered. Vascular causes of acute flank pain must always be considered, since these constitute life-threatening emergencies that may require the intravenous administration of contrast material for diagnosis. Radiologists must be familiar with the typical findings of urinary stone disease at unenhanced CT, as well as the spectrum of alternative diagnoses that may be detected with this modality, to accurately diagnose the source of flank pain.

Original languageEnglish
Pages (from-to)S11-S28
JournalRadiographics
Volume24
Issue numberSPEC. ISS.
DOIs
StatePublished - Oct 2004

Keywords

  • Computed tomography (CT), helical
  • Gastrointestinal tract, abnormalities, 70.12115
  • Genitourinary system, abnormalities, 80.12115 ureter, calculi, 82.81

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