Diuretic ultrasonography: its value in the diagnosis of lion pain

ABSTRACT

This study included one hundred patients complaining of loin pain, while their kidneys [under usual conditions] were sonographically normal. Diuretic ultrasonography was done for these, good orally hydrated, patients 15-20 minutes after intravenous injection of 40 mg furosemide. Patients with urinary tract infection, crystalluria and patients who had detectable cause on ultrasonographic examination without diuresis were excluded from the study. Out of these one hundred patients, 26% showed pelvicalyceal dilatation on diuretic ultrasonography [previously normal on ultrasonography without diuresis]. All except one showed down stream obstruction on confirmatory investigation [96% sensitivity]. None of the patients who were found to be normal on diuretic ultrasonography proved to have down stream obstruction [100% specificity]. Carefully performed, diuretic ultrasonography clearly distinguished patients with loin pain due to obstruction from those due to other causes. Therefore, the number of radiographic examination can be reduced to minimum and the problem of subtle ureteral obstruction can be resolved as well. Diuretic ultrasonography thus appears to be promising easy and noninvasive method for evaluation of patients complaining of loin pain