Diagnostic role of ultrasonography and X-RAY combined versus intravenous urography in evaluation of renal colic.

Objective: To determine the role of X-Ray and ultrasonography combined versus intravenous urography in diagnosing cause of renal colic. Study Design: Experimental study. Setting: Urology Department of Margalla Hospital PMO Taxila. Period: July to December 2019. Material & Methods: Cases presenting with renal colic in urology Out-Patient door Department suspecting renal stone, ureteric or PUJ obstruction were included in this study. Patients below 14 years, hypersensitivity to intravenous contrast media and renal failure or having any condition with deranged blood urea and creatinine level were excluded from the study. X-ray, ultrasonography of abdomen, KUB (kidney, ureter and urinary bladder) and intravenous urography was done in every patient included in the study. Results: Sample size was 200. Mean age of patients was 38.4±6.8 years. Right sided renal colic was more common (45%) than left sided (42.5%) and bilateral flank pain (12.5%). On IVU hydronephrosis with obstructing renal stone was found in 45.5% cases, ureteric stone in 40.5% and hydronephrosis with non-obstructing stone was found in 14% cases. On x-ray and ultrasonography KUB, hydronephrosis with obstructing renal stone found in  38.5% cases, ureteric stone in 13.5%, renal stone in 39.5% and hydronephrosis with non-obstructing stone was diagnosed in 6% cases. When results of x-ray ultrasonography compared with IVU, calculi were diagnosed in 53% cases (sensitivity 87% and specificity 100%), hydronephrosis was detected in 98 cases (sensitivity 97%, specificity 95%). Conclusion: X-ray KUB and ultrasonography combined have almost equal accuracy as intravenous urography in diagnosing renal colic.