Renal Ultrasound.

An introduction to renal point-of-care ultrasound (POCUS).

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About this course

Genitourinary ultrasound includes the evaluation of the bladder and the kidneys. While there are many potential applications of renal ultrasound in the emergency department, the most common indication for point-of-care renal ultrasound is the evaluation for hydronephrosis, which can be an indicator of urolithiasis in the setting of suspected renal colic.

Key concepts

  • Advantages of ultrasound over CT in the evaluation of genitourinary pathology include shorter length of stay, lower cost, and an improved safety profile
  • A recent systematic review and meta-analysis of 9 studies and 1,773 patients found that emergency provider performed ultrasound has a sensitivity of 70.2% and a specificity of 75.4% and a positive likelihood ratio of 2.85 and a negative likelihood ratio 0.39 for hydronephrosis indicating urolithiasis.
  • That same study did a subgroup analysis on 2 of the 9 studies that looked specifically at moderate hydronephrosis as a predictor of urolithiasis and found that in that population, POCUS had a specificity of 94.4%.