Utility of hematuria testing in patients with suspected renal colic: correlation with unenhanced helical CT results

Luchs, Jonathan S; Katz, Douglas S; Lane, Michael J; Mellinger, Brett C; Lumerman, Jeffrey H; Stillman, Charles A; Meiner, Evan M; Perlmutter, Steven

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Volume 59, Issue 6 , Pages 839-842, June 2002

Utility of hematuria testing in patients with suspected renal colic: correlation with unenhanced helical CT results

Jonathan S Luchs
- Department of Radiology, Winthrop-University Hospital, Mineola, New York, USA
- Department of Radiology, State University of New York at Stony Brook, Stony Brook, New York, USA
Douglas S Katz
- Reprint requests: Douglas S. Katz, M.D., Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA
- Department of Radiology, Winthrop-University Hospital, Mineola, New York, USA
- Department of Radiology, State University of New York at Stony Brook, Stony Brook, New York, USA
Michael J Lane
- Department of Radiology, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
Brett C Mellinger
- Department of Urology, Winthrop-University Hospital, Mineola, New York, USA
Jeffrey H Lumerman
- Department of Urology, Winthrop-University Hospital, Mineola, New York, USA
Charles A Stillman
- Department of Radiology, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
Evan M Meiner
- Department of Emergency Medicine, North-Shore University Hospital, Manhasset, New York, USA
Steven Perlmutter
- Department of Radiology, Winthrop-University Hospital, Mineola, New York, USA
- Department of Radiology, State University of New York at Stony Brook, Stony Brook, New York, USA

Received 12 December 2001; received in revised form 25 January 2002; accepted 25 January 2002.

Abstract

Objectives. To determine the utility of hematuria testing in a large series of patients with suspected renal colic using unenhanced helical computed tomography (CT) as the reference standard.

Methods. A retrospective review of the CT reports of all patients who underwent unenhanced helical CT for suspected renal colic at one institution during a 3.5-year period and who also underwent a formal microscopic urinalysis within 24 hours of the CT study was conducted. The sensitivity, specificity, positive predictive value, and negative predictive value of the presence of any blood on the urinalysis for renal colic were calculated.

Results. Urolithiasis was present in 587 (62%) of the 950 patients, and 363 patients had negative examinations for renal colic, including 69 with significant alternative diagnoses in the latter group. Of the urinalyses, 492 were true-positive, 174 were true-negative, 189 were false-positive, and 95 were false-negative, yielding a sensitivity, specificity, positive predictive value, and negative predictive value of 84%, 48%, 72%, and 65%, respectively. Forty-six percent of the urinalysis results were negative for blood in the subset of patients with significant alternative diagnoses.

Conclusions. The sensitivity of hematuria on microscopic urinalysis for renal colic using unenhanced CT as the reference standard was 84%, and the specificity and negative predictive value was low. The presence or absence of blood on urinalysis cannot be used to reliably determine which patients actually have ureteral stones.