Diagnostic Role of X-ray Imaging in Renal and Ureteric Calculi Keeping Computed Tomography as Gold Standard: Diagnostic Role of X-ray Imaging in Renal and Ureteric Calculi

Kalim Ullah; Tauseef Qamar; Siraj Khan; Bilal Ahmad

doi:10.54393/pbmj.v8i1.1205

Authors

Kalim Ullah Department of Radiology, Superior University, Lahore, Pakistan
Tauseef Qamar Department of Radiology, Superior University, Lahore, Pakistan
Siraj Khan Department of Radiology, Superior University, Lahore, Pakistan
Bilal Ahmad Department of Radiology, Superior University, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v8i1.1205

Keywords:

Kidney, Ureter and Bladder X-ray, Computed Tomography, Accuracy, Renal Colic, Urinary Stones

Abstract

The renal colic is an initial onset of flank discomfort that often radiates to the groin and may be linked with complication like hematuria and dysuria. Physicians initially use KUB plain x-ray imaging for the initial diagnosis and ultrasonography for the suspected calculi, and evaluation of the upper tract of urinary system. Objectives: To determine the diagnostic accuracy of x-ray KUB imaging in diagnosis of renal and ureteric calculi keeping computed tomographic scan as a gold standard. Methods: An ethically approved cross-sectional study was conducted at Maqsood Medical Complex, Peshawar with a convenient sampling technique between August to November 2024. Data of KUB x-ray and CT scan were collected by predesigned proforma. Data were entered in SPSS version 27. Demographics were described in tables and applied Chi square test for the sensitivity and specificity of the KUB radiographic x-ray take the CT scan gold standard. Results: The sample size of the study was 235, where the mean and standard deviation of age was 33.77 ± 8.61. The male patients were 152 (64.68%) and the female were 83 (35.32%) participated in this research study. The Chi square test result shows that x-ray was able to properly detect 92 cases of calculi verified by CT but missed 124 cases. While X-ray did not incorrectly identify any calculi. Conclusions: Although KUB x-ray imaging has been configured to be an initial diagnostic tool in detecting renal and ureteric calculi, its diagnostic yield lacks in comparison to CT scans.

References

Rooney L. The Renal System and Associated Disorders. Fundamentals of Applied Pathophysiology for Paramedics. 2024 Mar: 178-98. doi: 10.1002/9781394322237.ch9. DOI: https://doi.org/10.1002/9781394322237.ch9

Ahn JS and Harper JD. Acute Kidney Stone Management. A Clinical Guide to Urologic Emergencies. 2021 Aug: 64-82. doi: 10.1002/9781119021506.ch4. DOI: https://doi.org/10.1002/9781119021506.ch4

Nasar AA, Ahmad A, Saleem S, Bary A, Sarfraz J, Amjad M et al. Efficacy of IV Paracetamol in Patients with Renal Colic in Emergency Department. Indus Journal of Bioscience Research. 2024 Nov; 2(02): 541-5. doi: 10.70749/ijbr.v2i02.241. DOI: https://doi.org/10.70749/ijbr.v2i02.241

Siriwardana SR and Abeysuriya V. Radiological Investigations in Nephrolithiasis and: A Narrative Review. Sri Lanka Journal of Surgery. 2023 Dec; 41(03): 51-57. doi: 10.4038/sljs.v41i03.9075. DOI: https://doi.org/10.4038/sljs.v41i03.9075

Haidary M, Tiwari A, Chouhan AP, Verma A, Singh V. Advancements in Medical Imaging Technology for Investigating Urinary Disease: A Methodological Approach. MISJ-International Journal of Medical Research and Allied Sciences. 2024 Jun; 2(02): 72-82.

Mahamat MA, Diarra A, Kassogué A, Eyongeta D, Valentin V, Allah-Syengar N et al. Renal Colic: Epidemiological, Clinical Etiological and Therapeutic Aspects at the Urology Department of the National Reference General Hospital of N’Djamena (Chad). Open Journal of Urology. 2020 Jan; 10(02): 25. doi: 10.4236/oju.2020.102004. DOI: https://doi.org/10.4236/oju.2020.102004

Torabi M, Shojaee F, Mirzaee M. Prevalence of Renal Colic in the Emergency Departments: A Multi-Center Study. Hospital Practices and Research. 2021 Sep; 6(3): 123-6. doi: 10.34172/hpr.2021.23. DOI: https://doi.org/10.34172/hpr.2021.23

Alibrahim H, Swed S, Sawaf B, Alkhanafsa M, AlQatati F, Alzughayyar T et al. Kidney Stone Prevalence Among US Population: Updated Estimation from NHANES Data Set. Journal of Urology Open Plus. 2024 Nov; 2(11): e00115. doi: 10.1097/JU9.0000000000000217. DOI: https://doi.org/10.1097/JU9.0000000000000217

He M, Lin X, Lei M, Xu X, He Z. Risk Factors of Urinary Tract Infection After Ureteral Stenting in Patients with Renal Colic During Pregnancy. Journal of Endo-urology. 2021 Jan; 35(1): 91-6. doi: 10.1089/end.2020.0618. DOI: https://doi.org/10.1089/end.2020.0618

Siriwardana S and Piyabani C. Role of Imaging in Renal Infections: A Narrative Review. 2023 Dec. doi: 10.20944/preprints202312.1794.v1. DOI: https://doi.org/10.20944/preprints202312.1794.v1

Nordio OG, Tumanskia NV, Miahkov SO. Radiology of the Urinary System: Manual for the Students of the 3rd Year of Speciality “Medicine”. 2024.

Ellison JS and Thakrar P. The Role of Imaging in the Management of Stone Disease. In Diagnosis and Management of Pediatric Nephrolithiasis. Cham: Springer International Publishing. 2022 Aug; 117-142. doi: 10.1007/978-3-031-07594-0_8. DOI: https://doi.org/10.1007/978-3-031-07594-0_8

Farhan MU, Anees SH, Aftab MA, Zia KH, Qayum AB. Utilization of Non-Contrast Enhanced CT KUB in Patients with Suspected Renal Colic. Pakistan Journal of Medical Health Sciences. 2021; 15(12): 3737-40. doi: 10.53350/pjmhs2115123737. DOI: https://doi.org/10.53350/pjmhs2115123737

Fard AM and Fard MM. Evaluation of Office Stones in Kidney Patients and How to Form and Treat Them. Eurasian Journal of Science Technology. 2021; 2(2): 384-98.

Papatsoris A, Alba AB, Galán Llopis JA, Musafer MA, Alameedee M, Ather H et al. Management of Urinary Stones: State of the Art and Future Perspectives by Experts in Stone Disease. Italian Archive of Urology, Andrology: Official Organ of the Italian Society of Urological and Nephrological Ultrasound. 2024 Jun; 96(2): 12703. doi: 10.4081/aiua.2024.12703. DOI: https://doi.org/10.4081/aiua.2024.12703

Abdulrasheed H, Adenipekun A, Mohsin MS, Khattak MA, Elsayed W, Cheema H et al. Audit of the Acute Management of Renal Colic in District Hospitals within A National Health Service Trust. Cureus. 2024 Sep; 16(9): e69825. doi: 10.7759/cureus.69825. DOI: https://doi.org/10.7759/cureus.69825

Peracha J and Sinha S. Clinical Assessment of Renal Disease and Identification of Kidney Disease in the Community. Medicine. 2023 Feb; 51(2): 89-97. doi: 10.1016/j.mpmed.2022.11.008. DOI: https://doi.org/10.1016/j.mpmed.2022.11.008

Kumahor EK. The Biochemical Basis of Renal Diseases. In Current Trends in the Diagnosis and Management of Metabolic Disorders. 2024: 185-200. doi: 10.1201/9781003384823-11. DOI: https://doi.org/10.1201/9781003384823-11

Yang K, Shang Y, Yang N, Pan S, Jin J, He Q. Application of Nanoparticles in the Diagnosis and Treatment of Chronic Kidney Disease. Frontiers in Medicine. 2023 Apr; 10: 1132355. doi: 10.3389/fmed.2023.1132355. DOI: https://doi.org/10.3389/fmed.2023.1132355

Jan Jr BR, Martin CH, Michaela MI, Jan Sr BR, Zuzana ZI. Overview of Urological Complications Before, During and After Kidney Transplantation. Bratislava Medical Journal/Bratislavské Lekárske Listy. 2022 Aug; 123(8). doi: 10.4149/BLL_2022_089. DOI: https://doi.org/10.4149/BLL_2022_089

Rizvi SF-u-H, Mustafa G, Kundi A, Khan MA. Prevalence of Congenital Heart Disease in Rural Communities of Pakistan. Journal of Ayub Medical College Abbottabad. 2015; 27(1): 124-7.

Eurboonyanun K, Rungwiriyawanich P, Chamadol N, Promsorn J, Eurboonyanun C, Srimunta P. Accuracy of Nonenhanced CT vs Contrast-Enhanced CT for Diagnosis of Acute Appendicitis in Adults. Current Problems in Diagnostic Radiology. 2021 May; 50(3): 315-20. doi: 10.1067/j.cpradiol.2020.01.010. DOI: https://doi.org/10.1067/j.cpradiol.2020.01.010

Raza MA, Ghazanfar S, Mahrukh F, Altuf L, Shah L, Tufail M, et al. Diagnostic Accuracy of Non-Contrast Computed Tomography in Identification of Renal Calculi in Suspected Patients with Negative Intravenous Pyelogram. Journal of Health and Rehabilitation Research. 2024 May; 4(2): 1078-82. doi: 10.61919/jhrr.v4i2.882. DOI: https://doi.org/10.61919/jhrr.v4i2.882

Desai V, Cox M, Deshmukh S, Roth CG. Contrast-Enhanced or Noncontrast CT for Renal Colic: Utilizing Urinalysis and Patient History of Urolithiasis to Decide. Emergency Radiology. 2018 Oct; 25: 455-60. doi: 10.1007/s10140-018-1604-0. DOI: https://doi.org/10.1007/s10140-018-1604-0

Yang B, Suhail N, Marais J, Brewin J. Do Low Dose CT-KUBs Really Expose Patients to More Radiation than Plain Abdominal Radiographs? Urologia Journal. 2021 Nov; 88(4): 362-8. doi: 10.1177/0391560321994443. DOI: https://doi.org/10.1177/0391560321994443

Ashraf H, Saulat S, uddin Qadri SS, Amin D, Ayub A, Ejaz M. All That Glitter is not Gold: Computed Tomography-Kidney Ureter Bladder (CT-KUB) is Not Necessary for a Safe Percutaneous Nephrolithotomy. Pakisan Journal of Medicine and Dentistry. 2022; 11(2): 36-43. doi: 10.36283/pjmd11-2/007. DOI: https://doi.org/10.36283/PJMD11-2/007