First 10EM -By Justin Morgenstern - June 1, 2020
"The paper
Moore CL, Carpenter CR, Heilbrun ME, et al. Imaging in Suspected Renal Colic: Systematic Review of the Literature and Multispecialty Consensus. Ann Emerg Med. 2019;74(3):391–399. PMID: 31402153 DOI: 10.1016/j.annemergmed.2019.04.021
Bottom line
The older a patient is, and the less sure you are about the diagnosis of renal colic, the more benefit there will be from CT. In younger patients with a clear diagnosis, no imaging is required at all. For intermediate patients, ultrasound is a great starting point.
I will reiterate my initial thought: imaging for renal colic is pretty easy. It is required if you are searching for an alternative diagnosis. It is required if the patient is septic and needs the OR urgently. It is required if the patient’s pain can’t be controlled and a surgical intervention might be required. Otherwise, it generally isn’t necessary."