• Salman Tahir Shafi, Roshina Anjum, and Tahir Shafi.
• Dr. Salman Tahir Shafi, FACP, FASN. Diplomat American Board of Internal Medicine and Nephrology, Department of Nephrology, Sharif Medical and Dental College, Sharif Medical City Road Jati Umra, Lahore, Pakistan.
• Pak J Med Sci. 2017 May 1; 33 (3): 545-548.

ObjectiveTo determine any clinical features associated with an abnormal ultrasound in patients with suspected nephrolithiasis in an out-patient setting.MethodsThe study design was cross-sectional in nature. The study was conducted at an out-patient nephrology department of a tertiary care facility over a 3 month period. Patients included in the study were 18-80 years old, who presented with unilateral flank or costovertebral angle pain with or without other clinical features suggestive of renal or ureteric calculus based on clinician's judgement. Every patient's history was reviewed to obtain information on age, gender, location and radiation of pain, onset, severity and nature of pain, associated urinary and systemic symptoms and past history of nephrolithiasis. An ultrasound was considered to be abnormal if there was documented presence of renal or ureteric stone and/or unilateral hydronephrosis.ResultsA total of 209 patients were included in the study. Of these patients, 126 (60.3%) were males and 83 (39.7%) were females, 60 (28.7%) had prior history of nephrolithiasis. Ultrasound was abnormal in 110 patients (52.9%). On a multivariate logistic regression analysis, only past history of nephrolithiasis (OR 3.3, 95% CI 1.65-6.7) was associated with an abnormal ultrasound.ConclusionIn the absence of any significant clinical predictors use of ultrasound is justified in patients with suspected nephrolithiasis especially in those with prior history of stones.

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