The test of choice for the diagnosis of ureteral obstruction secondary to renal lithiasis is
A) Noncontrast helical computed tomography (CT)
B) Ultrasound
C) Intravenous pyelogram
D) Magnetic resonance imaging (MRI)
E) Plain radiographs
Answer and Discussion
The answer is A. Noncontrast helical computed tomography (CT)
The most common cause of the sudden onset of flank pain in adults is acute urolithiasis. Identification of a stone in the ureter with resultant partial or complete ureteral obstruction confirms the suspected diagnosis.
Noncontrast helical CT has the advantages of avoiding contrast exposure, identifying radiolucent calculi, evaluating nearby structures and requires a shorter time for examination. As a result, helical CT is a better test for assessing acute urolithiasis.
Abdominal ultrasound has a high specificity in evaluating stones, but its sensitivity is lower than helical CT.
Plain films are used to follow patients with known radiopaque (i.e., calcium) stones.
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