CT for Suspected Renal Colic Yields Incidental Findings

More than 12% of non-enhanced CT scans performed in the ER for suspected renal colic detected important incidental findings (IFs), according to a study published in the Journal of the American College of Radiology.

Researchers from Yale University School of Medicine in New Haven, CT undertook a retrospective record review to determine the prevalence, importance, and types of IFs in non-enhanced CT scans performed for suspected renal colic.

A total of 5,383 consecutive finalized reports of non-enhanced CT using renal colic protocol performed on 4,845 adult patients over a 5.5-year period were reviewed. The researchers defined IFs as those unrelated to symptoms, not as alternate causes of symptoms. If follow-up was recommended, based on recently published consensus recommendations, they were categorized as “important.”

The reviewers identified 875 important IFs in 681 CT scans (12.7%), with the prevalence increasing with patient age. Patients over 80 years old had 28.9% prevalence compared with 6.9% among patients aged 18 to 30. Although not statistically significant, the researchers also noted that women had a higher prevalence of IF (13.4%) compared with men (11.9%).

Most commonly found IFs:

Within the female pelvis, 122 of 159 important IFs (77%) occurred in the adnexa, 32 (20%) in the uterus, and 5 (3%) in the vagina.

The researchers concluded that further study be done using radiographic recommendations to characterize IF and examine the outcome and cost of workup.