Table 1 Alternative diagnoses in patients with renal colic
From: Imaging patients with renal colic—consider ultrasound first
Entities | Most common US findings |
Pyelonephritis | Mild disease may demonstrates no abnormality Renal enlargement Intra- or extrarenal fluid collections or abscesses may be present |
Renal mass | Renal tumour (detection depends on tumour size) Spontaneous subcapsular or perinephric bleeds may cause flank pain |
Adnexal pathology: | |
Hemorrhagic ovarian cysts | Heterogeneous cyst |
Pelvic inflammatory disease | Thickened, dilated fallopian tube. Abscesses |
Endometriomas | Cyst with diffuse homogenous low-level internal echoes |
Ovarian torsion | Enlarged hypo or hyperechoic ovary with little or no intra-ovarian venous flow. In some cases twisted vascular pedicle is observed. |
Ovarian neoplasms | Ovarian masses |
Appendicitis | Noncompressible appendix with diameter >6 mm |
Diverticulitis | Detection of diverticulum Signs of inflammation of fat (dirty fat/stranding) Thickened bowel wall >4–5 mm Pericolic fluid or collections |
Dissection/ruptured aneurysms | Thin membrane fluttering in the aortic lumen Dilatation of the aorta >3 cm, periaortic fluid collection |