Diagnostic Accuracy of Ultrasonography Combined with the S.T.O.N.E. Criteria in Patients Suspected of Acute Ureteral Stone

Haeri, Dorsa; Safavi, Mohammad Reza; Fahimi, Mohamadali; Barzegari, Mohamad Hassan; Mozaffari, Javad; Sabeti, Fariba

doi:10.48305/jims.v43.i848.2047

Diagnostic Accuracy of Ultrasonography Combined with the S.T.O.N.E. Criteria in Patients Suspected of Acute Ureteral Stone

Document Type : Original Article(s)

Authors

Dorsa Haeri ¹

Mohammad Reza Safavi ²

Mohamadali Fahimi ³

Mohamad hassan Barzegari ³

Javad Mozaffari ⁴

Fariba Sabeti ⁵

¹ Medical Student, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

² Department of Anesthesiology, School of Isfahan University of Medical Sciences, Isfahan, Iran

³ Department of Emergency Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

⁴ Department of Emergency Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

⁵ Department of Emergency Medicine, School of Medicine, Ahvaz Jun-dishapur University of Medical Sciences, Ahvaz, Iran

10.48305/jims.v43.i848.2047

Abstract

Background:
Renal colic is a common emergency department presentation, typically evaluated by CT scan. This study assesses the diagnostic value of combining bedside ultrasound with the STONE score as a safer alternative for suspected ureteral stones.
Methods:
In this prospective study, 176 patients with renal colic symptoms were stratified by STONE scores into low-, moderate-, and high-risk groups. Bedside ultrasound findings were compared against CT results. Statistical analysis included sensitivity, specificity, and ROC curve evaluation.
Results:
Ureteral stones were confirmed by CT in 101 patients (57.4%). Hydronephrosis was present in 78.2% of stone-positive versus 17.3% of stone-negative patients. Ultrasound showed 75%/89.2% (sensitivity/specificity) in low-risk, 74%/56.3% in moderate-risk, and 83%/42.9% in high-risk groups. The AUC was 0.78 for ultrasound alone versus 0.75 for the combined model.
Conclusion:
The ultrasound-STONE score combination reliably screens for ureteral stones in low/moderate-risk patients, potentially reducing unnecessary CT scans. CT remains preferred for high-risk cases due to ultrasound's limited specificity in this group.

Keywords

Renal colic

Ultrasonography

Emergency medicine

Ureterolithiasis

Subjects