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Ultrasound appears to be best in most renal colic clinical scenarios. CT is best in older patients (especially with no stone history), those with tenderness on abdominal exam, and those with uncontrolled pain.
The IDSA now only recommends screening for and treating asymptomatic bacteriuria (ASB) in pregnant women and those undergoing an invasive urologic procedure.
Highly resistant, extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae in the urine are becoming increasingly common in unexpected patients in the ED.
Neither IV magnesium nor intranasal desmopressin provided any additional pain relief when used as an adjunct to NSAIDs for renal colic.
There was a helpful JAMA Internal Medicine article on caring for transgender patients this past month. This will help us apply it in the ED.
This large RCT found tamsulosin was of no benefit for kidney stone passage at 28 days, regardless of size or location.
Point-of-care ultrasound in patients with renal colic had tepid diagnostic accuracy for nephrolithiasis. If hydronephrosis was present, specificity was 94% and often indicated a stone >5mm.
Nitrofurantoin was clearly superior to fosfomycin for uncomplicated UTI in adult women.
An ultrasound-first strategy, especially for recurrent kidney stones, was a good way to reduce radiation exposure in patients presenting to the ED with renal colic.
Consider testicular torsion a surgical emergency even if it is past the usual 6-8 hour mark, which is traditionally taught as the outer limit of testicular viability. This study found that the testicle could still be salvaged over half the time from 13-24 hours from onset.