Diagnostic Accuracy of Ultrasonography Combined With the S.T.O.N.E. Criteria in Patients Suspected of Acute Ureteral Stone; [بررسی ارزش تشخیصی سونوگرافی کنار تخت در ترکیب با نمره Stone در بیماران مشکوک به سنگ حالب یک مطالعه ی آینده نگر] Publisher

Summary: Can bedside scans avoid some kidney stone CTs? A study found ultrasound plus STONE score may aid low-risk screening, while high-risk cases still need CT. #KidneyStones #EmergencyMedicine

Haeri D ; Safavi M R ; Fahimi M ; Barzegari M H ; Mozaffari J ; Sabeti F
Source: Journal of Isfahan Medical School Published:2026

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. Findings: 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. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.