II. Indications

  1. Suspected uncomplicated Ureteral Stone in patients with normal Renal Function

III. Contraindications

  1. Fever or signs of infection
  2. Ill appearing patients
  3. Elderly patients
  4. Trauma or recent urologic surgery
  5. Active cancer

IV. Criteria

  1. Gender
    1. Score 0: Female Gender
    2. Score 2: Male Gender
  2. Duration
    1. Score 0: Lasting >24 hours
    2. Score 1: Lasting 6 to 24 hours
    3. Score 3: Lasting <6 hours
  3. Nausea and Vomiting
    1. Score 0: None
    2. Score 1: Nausea only
    3. Score 2: Nausea and Vomiting
  4. Hematuria (on Urine Dipstick)
    1. Score 0: None
    2. Score 3: Present
  5. Race (Optional)
    1. Score 0: Black
    2. Score 3: Non-Black

V. Interpretation

  1. Score 0 to 5: Low Risk for Stone (9.2%)
    1. Alternative diagnosis is more likely
  2. Score 6 to 9: Moderate Risk for Stone (51.3%)
    1. Consider expectant management without CT if Hydronephrosis on Bedside Ultrasound (after hydration) in otherwise healthy patient
    2. Bedside Ultrasound may also be used to help exclude other important diagnoses (e.g. AAA, acute cholelithaisis)
  3. Score 10 to 13: High Risk for Stone (88.6%)
    1. Consider expectant management without CT in pain-controlled patients at low risk for alternative diagnosis
    2. Bedside Ultrasound may increase accuracy by identifying Hydronephrosis and excluding alternative diagnoses
    3. Low dose CT may be considered if stone localization and size is needed

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