Similarly, Oner et al [48] showed that US correctly found stones in 78% of patients, although it only found 25% of ureteral stones. The same study by Masch et al [63] showed that US has a sensitivity of only 31% for renal stone detection if an echogenic focus, posterior acoustic shadowing, and twinkling artifact are all required findings to make a diagnosis. US is still recommended by some as a first-line screening test and, if positive, can then direct patient management [48,49,64], with the caveat that a negative US does not exclude stone disease [49]. Radiography Levine et al [47] in a study of 178 adult and pediatric patients found radiographs had a 59% sensitivity for stone detection. IVU IVU is seldom indicated in children as an initial examination, although a limited study may provide information about stone position, degree of urinary tract obstruction, and movement after initial diagnosis. MRI MRI is not appropriate in the initial evaluation of painful hematuria and suspected urolithiasis. VCUG VCUG is not appropriate in the initial evaluation of painful hematuria and suspected urolithiasis. Voiding Urosonography Voiding urosonography is not appropriate in the initial evaluation of painful hematuria and suspected urolithiasis. Arteriography Renal arteriography is not appropriate in the evaluation of painful hematuria and suspected urolithiasis. 8 If the abdominal and pelvic CT is used as the criterion standard for identifying urologic trauma in children, the microscopic urinalysis has moderate discriminatory power to predict urologic injury [77]. Patients with gross hematuria and pelvic fractures are at high risk for bladder rupture [81,82]. The conventional fluoroscopic cystogram requires moving the patient to another imaging suite.
Hematuria Child. Similarly, Oner et al [48] showed that US correctly found stones in 78% of patients, although it only found 25% of ureteral stones. The same study by Masch et al [63] showed that US has a sensitivity of only 31% for renal stone detection if an echogenic focus, posterior acoustic shadowing, and twinkling artifact are all required findings to make a diagnosis. US is still recommended by some as a first-line screening test and, if positive, can then direct patient management [48,49,64], with the caveat that a negative US does not exclude stone disease [49]. Radiography Levine et al [47] in a study of 178 adult and pediatric patients found radiographs had a 59% sensitivity for stone detection. IVU IVU is seldom indicated in children as an initial examination, although a limited study may provide information about stone position, degree of urinary tract obstruction, and movement after initial diagnosis. MRI MRI is not appropriate in the initial evaluation of painful hematuria and suspected urolithiasis. VCUG VCUG is not appropriate in the initial evaluation of painful hematuria and suspected urolithiasis. Voiding Urosonography Voiding urosonography is not appropriate in the initial evaluation of painful hematuria and suspected urolithiasis. Arteriography Renal arteriography is not appropriate in the evaluation of painful hematuria and suspected urolithiasis. 8 If the abdominal and pelvic CT is used as the criterion standard for identifying urologic trauma in children, the microscopic urinalysis has moderate discriminatory power to predict urologic injury [77]. Patients with gross hematuria and pelvic fractures are at high risk for bladder rupture [81,82]. The conventional fluoroscopic cystogram requires moving the patient to another imaging suite.