ArticleUrology practice2026
Diagnostic Imaging for Suspected Nephrolithiasis in United States Emergency Departments.
Article in Urology practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
introductionCT and ultrasound (US) are primary imaging modalities for evaluating flank pain and suspected nephrolithiasis in emergency departments (EDs). Prior evidence suggests that initial US instead of CT reduces radiation exposure without serious clinical consequences. We investigated trends in imaging used for evaluating flank pain in United States EDs.
methodsED encounters for flank pain were identified in the National Hospital Ambulatory Medical Care Survey (2014-2022). National estimates were generated through multistage survey weighting. Multivariate logistic regression models controlling for demographic and visit characteristics were used to calculate adjusted odds ratios (aORs) and α = .01.
resultsAmong an estimated 25.4 million ED encounters for flank pain, 24.2% resulted in a nephrolithiasis diagnosis. The annual rate of nephrolithiasis diagnoses was similar throughout the study period. Imaging utilization included CT-exclusive (53.3%), US-exclusive (5.6%), combined CT and US (4.6%), and neither CT nor US (36.4%) workups. CT-exclusive (aOR: 1.050,
conclusionsCT remains the predominant imaging modality for flank pain evaluation and has increased in use since 2014, while US-exclusive evaluation remains limited to select settings and patient populations.
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