Hydronephrosis diagnostic study of choice: Difference between revisions

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__NOTOC__
__NOTOC__
{{Hydronephrosis}}
{{Hydronephrosis}}
{{CMG}}; {{AE}}
{{CMG}}; {{AE}} {{VKG}}
== Overview ==
== Overview ==
[[Renal]] [[ultrasonography]] is the [[Gold standard test|diagnostic study of choice]] for the [[diagnosis]] of [[hydronephrosis]]. Early diagnosis of [[hydronephrosis]] is important because most of the cases can be reversed if treated promptly which can prevent [[irreversible]] renal injury. 


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==


=== Study of choice ===
=== Study of choice ===
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* [[Renal]] [[ultrasonography]] is the [[Gold standard test|diagnostic study of choice]] for the [[diagnosis]] of [[hydronephrosis]].<ref name="pmid416685">{{cite journal |vauthors=Ellenbogen PH, Scheible FW, Talner LB, Leopold GR |title=Sensitivity of gray scale ultrasound in detecting urinary tract obstruction |journal=AJR Am J Roentgenol |volume=130 |issue=4 |pages=731–3 |date=April 1978 |pmid=416685 |doi=10.2214/ajr.130.4.731 |url=}}</ref>
* The following result of [gold standard test] is confirmatory of [disease name]:
* The following results of [[ultrasonography]] is confirmatory of [[hydronephrosis]]:<ref name="pmid4166852">{{cite journal |vauthors=Ellenbogen PH, Scheible FW, Talner LB, Leopold GR |title=Sensitivity of gray scale ultrasound in detecting urinary tract obstruction |journal=AJR Am J Roentgenol |volume=130 |issue=4 |pages=731–3 |date=April 1978 |pmid=416685 |doi=10.2214/ajr.130.4.731 |url=}}</ref><ref name="pmid3070720">{{cite journal |vauthors=Kuuliala IK, Niemi LK, Ala-Opas MY |title=Ultrasonography for diagnosis of obstructing ureteral calculus |journal=Scand. J. Urol. Nephrol. |volume=22 |issue=4 |pages=275–7 |date=1988 |pmid=3070720 |doi= |url=}}</ref><ref name="pmid7281377">{{cite journal |vauthors=Talner LB, Scheible W, Ellenbogen PH, Beck CH, Gosink BB |title=How accurate is ultrasonography in detecting hydronephrosis in azotemic patients? |journal=Urol Radiol |volume=3 |issue=1 |pages=1–6 |date=1981 |pmid=7281377 |doi= |url=}}</ref><ref name="pmid28611874">{{cite journal |vauthors=Leo MM, Langlois BK, Pare JR, Mitchell P, Linden J, Nelson KP, Amanti C, Carmody KA |title=Ultrasound vs. Computed Tomography for Severity of Hydronephrosis and Its Importance in Renal Colic |journal=West J Emerg Med |volume=18 |issue=4 |pages=559–568 |date=June 2017 |pmid=28611874 |pmc=5468059 |doi=10.5811/westjem.2017.04.33119 |url=}}</ref>
** Result 1
** Hypoechoic fluid displaces the [[echogenic]] sinus [[fat]]  
** Result 2
** Anechoic black area
* The [name of the investigation] should be performed when:
** Can detect dilation of the [[proximal]] renal [[pelvis]] of the kidney due to obstruction
** The patient presented with symptoms/signs 1. 2, 3.
** Can detect dilation of the [[renal pelvis]] and calyces of the kidney due to obstruction
** A positive [test] is detected in the patient.
** Can detect thinning of the [[renal cortex]]
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* The diagnostic study of choice for [disease name] is [name of the investigation].
* There is no single diagnostic study of choice for the diagnosis of [disease name].  
* There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
* [Disease name] is mainly diagnosed based on clinical presentation.
* Investigations:
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.


==== The comparison of various diagnostic studies for [disease name] ====
==== The comparison of diagnostic studies for [[hydronephrosis]] ====
{|
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Positive predictive value
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Negative predictive value
!Sensitivity
|-
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
! style="background: #696969; color: #FFFFFF; text-align: center;" |[[Ultrasonography]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
| style="background: #DCDCDC; padding: 5px; text-align: center;" |0.77
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |0.71
|-
|98%<ref name="pmid30707202">{{cite journal |vauthors=Kuuliala IK, Niemi LK, Ala-Opas MY |title=Ultrasonography for diagnosis of obstructing ureteral calculus |journal=Scand. J. Urol. Nephrol. |volume=22 |issue=4 |pages=275–7 |date=1988 |pmid=3070720 |doi= |url=}}</ref>
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
|}
|}
<small> ✔= The best test based on the feature </small>
===== Diagnostic results =====
The following result of [investigation name] is confirmatory of [disease name]:
* Result 1
* Result 2
===== Sequence of Diagnostic Studies =====
The [name of investigation] should be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
* A positive [test] is detected in the patient, to confirm the diagnosis.
=== Diagnostic Criteria ===
* Here you should describe the details of the diagnostic criteria.
*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for the diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
** Criteria 1
** Criteria 2
** Criteria 3
IF there are clear, established diagnostic criteria:
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
IF there are no established diagnostic criteria: 
*There are no established criteria for the diagnosis of [disease name].


[[File:Kidney Stones On Ultrasound.jpg|alt=Kidney Stones|center|thumb|Case courtesy of Dr Amr Refat, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/25562">rID: 25562</a>]]


==References==
== References ==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 18:07, 12 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]

Overview

Renal ultrasonography is the diagnostic study of choice for the diagnosis of hydronephrosis. Early diagnosis of hydronephrosis is important because most of the cases can be reversed if treated promptly which can prevent irreversible renal injury.

Diagnostic Study of Choice

Study of choice

The comparison of diagnostic studies for hydronephrosis

Test Positive predictive value Negative predictive value Sensitivity
Ultrasonography 0.77 0.71 98%[6]
Kidney Stones
Case courtesy of Dr Amr Refat, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/25562">rID: 25562</a>

References

  1. ↑ Ellenbogen PH, Scheible FW, Talner LB, Leopold GR (April 1978). "Sensitivity of gray scale ultrasound in detecting urinary tract obstruction". AJR Am J Roentgenol. 130 (4): 731–3. doi:10.2214/ajr.130.4.731. PMID 416685.
  2. ↑ Ellenbogen PH, Scheible FW, Talner LB, Leopold GR (April 1978). "Sensitivity of gray scale ultrasound in detecting urinary tract obstruction". AJR Am J Roentgenol. 130 (4): 731–3. doi:10.2214/ajr.130.4.731. PMID 416685.
  3. ↑ Kuuliala IK, Niemi LK, Ala-Opas MY (1988). "Ultrasonography for diagnosis of obstructing ureteral calculus". Scand. J. Urol. Nephrol. 22 (4): 275–7. PMID 3070720.
  4. ↑ Talner LB, Scheible W, Ellenbogen PH, Beck CH, Gosink BB (1981). "How accurate is ultrasonography in detecting hydronephrosis in azotemic patients?". Urol Radiol. 3 (1): 1–6. PMID 7281377.
  5. ↑ Leo MM, Langlois BK, Pare JR, Mitchell P, Linden J, Nelson KP, Amanti C, Carmody KA (June 2017). "Ultrasound vs. Computed Tomography for Severity of Hydronephrosis and Its Importance in Renal Colic". West J Emerg Med. 18 (4): 559–568. doi:10.5811/westjem.2017.04.33119. PMC 5468059. PMID 28611874.
  6. ↑ Kuuliala IK, Niemi LK, Ala-Opas MY (1988). "Ultrasonography for diagnosis of obstructing ureteral calculus". Scand. J. Urol. Nephrol. 22 (4): 275–7. PMID 3070720.

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