A clinical prediction rule for the diagnosis of ureteral calculi in emergency departments

Objective: To determine: 1) whether a simple clinical prediction rule could identify emergency department patients with ureteral calculi; 2) whether the kidney, ureter, and bladder (KUB) radiograph provides diagnostic information beyond that obtained from the history and physical examination; and 3) whether ureteral calculi can be diagnosed accurately in the emergency department without emergency excretory urography, commonly known as intravenous pyelography (IVP). Patients: Two hundred three patients who underwent emergency KUB and IVP studies for nontraumatic abdominal or flank pain (derivation group) were retrospectively identified from radiology department records; 72 patients were prospectively evaluated in the emergency department for suspected ureteral stones (validation group).