Journal of Isfahan Medical School

Journal of Isfahan Medical School

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 3
Fariba Sabeti 4
1 Medical Student, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2 Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Assistant Professor, Department of Emergency Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
4 Resident of Emergency Medicine, Department of Emergency Medicine, School of Medicine, Ahvaz Jundishapur 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.

Highlights

Mohammad Reza Safavi :PubMed , Google Scholar

Fariba Sabeti: PubMed , Google Scholar

Keywords
Renal colic
Ultrasonography
Emergency medicine
Ureterolithiasis
Subjects
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Journal of Isfahan Medical School
Volume 43, Issue 848
4th Week, March
March and April 2026
Pages 2047-2053

  • Receive Date 26 April 2025
  • Accept Date 21 February 2026