emDocs - November 8, 2017 - Author: Crain N - Edited by: Koyfman A and Long B
"Summary:
- Flank pain and hematuria are the hallmarks of renal colic, however the presentation is variable.
- Diagnosis can be confirmed with CT scan, which will show most other potential items in the differential if the scan is negative for a stone.
- Patients with a good story for stone who are young and healthy at baseline can receive renal US to evaluate for hydronephrosis, rather than CT.
- Nephrolithiasis and nearly all of its mimics are confirmed with imaging.
- Some mimics of renal colic that may arrive at the ED include: upper UTI’s, ectopic pregnancies, ovarian torsion, adnexal masses, testicular torsion, acute aortic syndromes, renal artery aneurysms, renal infarction, splenic infarction, bowel obstruction, diverticulitis, appendicitis, biliary colic, cholecystitis, acute intestinal ischemia, pneumonia, pulmonary embolism, retroperitoneal hematoma, iliopsoas abscess.
- Focused history and physical exam are paramount due to the multitude of structures in the area and potentially dangerous conditions that may mimic renal colic."