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Answer: D--Abdomen and pelvis with contrast. According to the 2011 ACR appropriateness criteria, acute onset flank pain with clinical suspicion of nephrolithiasis is best addressed first with a CT Abdomen and Pelvis without contrast, reduced-dose techniques preferred. If CT without contrast does not explain pain or if an abnormality is detected on CT without contrast, a CT with contrast should be performed.
Question: According to the ACR appropriateness criteria, what is the best initial diagnostic test if you suspect nephrolithiasis AND the patient is a pregnant female?
- Abdominal radiograph (KUB)
- Renal and bladder ultrasound
- CT Abdomen and pelvis with contrast
- CT abdomen and pelvis without contrast
- CT Abdomen with contrast
- CT Abdomen without contrast
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