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Updated: Dec 22, 2025
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Author Spotlight: Developing a Bedside Protocol for Kidney and Genitourinary Ultrasonography
Published on: June 21, 2024
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ACR Appropriateness Criteria® Hematuria.
, Darcy J Wolfman1, Jamie Marko2
1Johns Hopkins University School of Medicine, Washington, District of Columbia.
Summary
Hematuria evaluation requires thorough patient assessment before imaging. This review outlines appropriate imaging strategies for various hematuria clinical scenarios based on evidence-based guidelines.
Area of Science:
- Radiology
- Urology
- Medical Imaging
Background:
- Hematuria, or blood in urine, is a frequent indication for urinary tract imaging.
- Comprehensive history, physical exam, urinalysis, and serologic testing are crucial before initial imaging.
Purpose of the Study:
- To provide evidence-based guidelines for the initial imaging of hematuria.
- To address specific clinical scenarios including microhematuria and gross hematuria.
Main Methods:
- Utilizes the American College of Radiology Appropriateness Criteria.
- Incorporates analysis of peer-reviewed literature and established methodologies (RAND/UCLA, GRADE).
- Expert opinion supplements evidence where necessary.
Main Results:
- Discusses imaging appropriateness for microhematuria (with/without risk factors, pregnancy) and gross hematuria.
- Highlights common imaging modalities: Ultrasound, CT, and MRI.
Conclusions:
- Recommends a systematic approach to hematuria imaging based on clinical context.
- Emphasizes the role of evidence-based guidelines in appropriate test selection.
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