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Author Spotlight: Developing a Bedside Protocol for Kidney and Genitourinary Ultrasonography
Published on: June 21, 2024
Imaging in the diagnosis of pediatric urolithiasis
Gabrielle C Colleran1, Michael J Callahan2, Harriet J Paltiel2
1Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02116, USA. gabrielle.colleran@childrens.harvard.edu.
Insights
Pediatric urolithiasis, or kidney stones in children, is rising. Ultrasound is recommended first, with CT used judiciously to ensure accurate diagnosis and appropriate care.
Area of Science:
- Pediatric Radiology
- Medical Imaging
- Urology
Background:
- Pediatric urolithiasis is a growing cause of illness and hospitalization in children.
- Ultrasound (US) is the preferred initial imaging method for suspected pediatric kidney stones.
- Computed tomography (CT) is frequently used as a first-line test despite US recommendations.
Purpose of the Study:
- To review current imaging techniques for diagnosing pediatric urolithiasis.
- To provide an imaging algorithm prioritizing US and defining CT's role.
- To highlight the importance of collaboration between pediatric and general radiology.
Main Methods:
- Review of current literature and imaging guidelines for pediatric urolithiasis.
- Development of a diagnostic imaging algorithm for pediatric urolithiasis.
- Emphasis on the role of the pediatric radiologist in appropriate imaging selection.
Main Results:
- Ultrasound is the recommended primary imaging modality for pediatric urolithiasis.
- Computed tomography should be used selectively with clear indications.
- Effective communication and collaboration between radiology departments are crucial.
Conclusions:
- An imaging algorithm prioritizing US can optimize the diagnosis of pediatric urolithiasis.
- Judicious use of CT, guided by clear indications, is essential.
- Enhanced collaboration between pediatric and general radiology improves patient care.
Abstract:
Pediatric urolithiasis is an important and increasingly prevalent cause of pediatric morbidity and hospital admission. Ultrasound (US) is the recommended primary imaging modality for suspected urolithiasis in children. There is, however, widespread use of CT as a first-line study for abdominal pain in many institutions involved in pediatric care. The objective of this review is to outline state-of-the-art imaging modalities and methods for diagnosing urolithiasis in children. The pediatric radiologist plays a key role in ensuring that the appropriate imaging modality is performed in the setting of suspected pediatric urolithiasis. Our proposed imaging algorithm starts with US, and describes the optimal technique and indications for the use of CT. We emphasize the importance of improved communication with a greater collaborative approach between pediatric and general radiology departments so children undergo the appropriate imaging evaluation.
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