| Abstract: | Objectives : 1. To investigate the diagnostic accuracy of urinalysis and the plain abdominal radiograph in predicting positive intravenous pyelography for patients with a history and examination suggestive of ureteric colic. 2. To examine the disposition of patients presenting to the emergency department with ureteric colic. Methods : A retrospective cohort study set in a tertiary referral hospital emergency department over a 12‐month period was conducted. Three hundred and eighteen patients who presented with a provisional diagnosis of ureteric colic and had intravenous pyelography were identified from radiology department logs and emergency department discharge International Classification of Disease‐9 codes. Results : Three hundred and eighteen patients were identified. Sixty‐nine per cent had positive intravenous pyelography. Sensitivity and specificity of: urinalysis were 93% and 41%; abdominal X‐ray, 57% and 83%; and urinalysis plus abdominal X‐ray, 99% and 36%, respectively. Seventy‐seven per cent were admitted to the emergency department observation ward. Twenty‐seven per cent were subsequently admitted under the hospital’s urology service. Conclusions : Sex, haematuria and the presence of a calculus on abdominal X‐ray were all significant predictors of positive intravenous pyelography. Haematuria was sensitive but not specific for positive intravenous pyelography. The addition of the abdominal X‐ray marginally improves the diagnostic accuracy. |
