Patients who present to the emergency department (ED) or other ambulatory care setting commonly report abdominal and flank pain. Unfortunately, patient history and physical examination often lack the necessary sensitivity and specificity to accurately diagnose underlying etiologies without further testing. Focused bedside ultrasonography is a valuable diagnostic tool that can often facilitate a timely diagnosis for these patients.
Ultrasonography is especially important in determining the cause of the sudden onset of abdominal or flank pain, since patients with symptomatic abdominal aneurysms can be difficult to distinguish from those with renal colic. In fact, making an accurate diagnosis of ureteronephrolithiasis is especially important, since renal colic is the most common misdiagnosis in patients with missed abdominal aortic aneurysms.
The benefits of focused emergency renal sonography (FERS) include the following:
Decreases the time to diagnosis for obstructive uropathy
Helps accurately diagnose obstructive uropathy
Helps assess the degree of obstruction in renal colic
Helps rule out other, more dangerous, pathology (eg, symptomatic aortic aneurysm)
Helps identify obstructive causes of renal insufficiency
Is safe in pregnant patients and children and requires less radiation than either intravenous pyelography (IVP) or helical CT