Ultrasonography vs. CT for Suspected Nephrolithiasis

• Published in: The New England journal of medicine Vol. 371; no. 26; pp. 2529 - 2531
• Main Authors: Shaffer, Phillip B, Borgess, Mary P, Dewey, Marc, Schlattmann, Peter, Andreana, Lorenzo, Fiore, Marco, Smith-Bindman, Rebecca
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 25-12-2014
• Subjects: Computed tomography; Diagnosis; Female; Humans; Lithiasis; Male; Nephrolithiasis; Nephrolithiasis - diagnostic imaging; Pain; Tomography, X-Ray Computed; Ultrasonic imaging; Ultrasonography; Ultrasound
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMc1412853

To the Editor:
Smith-Bindman et al. (Sept. 18 issue)
1
address the diagnosis of nephrolithiasis. However, their patients presented with pain, a symptom of obstructive ureterolithiasis, not simple nephrolithiasis.
A meta-analysis
2
reported a sensitivity of 97% and a specificity of 95% for the detection of obstructive ureterolithiasis with computed tomography (CT). Smith-Bindman et al. report that CT has a much lower sensitivity and specificity for nephrolithiasis — 86% and 53%, respectively. In their article, the authors provide no images and no discussion of the diagnostic criteria for diagnosis of stones that would allow the reader to understand this anomaly. According to . . .