Diagnostic value of urinalysis combine with abdominal ultrasound in diagnosis of renal colic in Jordan

Abstract

To assess the yield of both urinalysis and abdominal ultrasound in diagnosing renal colic and abdominal pain at King Hassein Medical Centre in Amman, Capital city of Jordan. Methods: Eight hundred and forty three successive patients presented to the emergency room at King Hussein Medical Centre Hospital between August 2004-March 2005 with abdominal pain and flank pain mimicking renal colic. All patients gave complete medical history, and underwent physical examination and urine analysis invesgation for pyuria, hematuria and/or crystalluria. Then they had abdominal ultrasound and 51 patients had plain abdominal radiograph. Urine analysis and abdominal ultrasound examinations were evaluated using 2 x 2 contingency table for sensitivity, specificity, positive and negative predictive values. (Mean age (±SD) was found to be 33.2 ± 11.66 years; (range 15-60). Male: Female ratio was (1.4:1).) There were 72 (8%) abnormal urinalysis (pyurea, hematuria) and 222 (26.3%) abnormal abdominal U/S. Sixty-nine (24.5%) cases were related to urinary tract and prostate. Nephrolithiasis dominated the ultrasonic findings (44.9%) followed by hydronephrosis (33.3%), small kidneys in 5.8%, prostate pathology, 4.3%, double kidneys, nephrectomy and renal cyst in 2.9% each. Adult polycystic kidney disease and horseshoe kidneys constituted (1.5%). Non-renal ultrasonic findings included gall bladder stones found in two patients, epigastric mass, intrapelvic mass in one female nd hepatosplenomegaly in one patient. Combined urine analysis and ultrasound had a sensitivity of 12% (95% CI: 4-19) and specificity of 92% (95% CI: 89-96). Positive predictive value was 33% (95% CI: 14-52). While combined ultrasound and kidney, urinary bladder had a sensitivity of 83% (95% CI: 62-104) and a specificity of 60% (95% 17-103). The predictive value for positive results was 83% (95% CI: 62-104) and the predictive value for negative results was 60% (95% CI: 17-103). Nephrolithiasis and hydronephrosis constutute the major causes of renal colic in Amman/Jordan.


Keywords: renal colic, Amman-Jordan, ultrasound, urinalysis, sensitivity, specificity

Mary Slessor Journal of Medicine Vol. 5 (1), 2005: 57-60