Quote:
Originally Posted by WilliamTheIrish
Accumulated dose is an overriding factor in medicine. About 20 years ago, I attended my first dose reduction conference. It really opened eyes about the technical factors used and taught to end users. Just after the turn of the century, end users were using a one size fits all technique. Even for children. Images were incredible. Just outstanding.
And nobody thought much about dose. Since that conference, we worked with a group from Duke University setting up pediatric weight based protocols reducing dose by 75%.
As for the 2% claim, I’d like to see what that’s based on. The risk/benefit factor plays a large role in CT usage. And yes, while you can localize a stone in renal pelvis or lower pole with US, a urologist wants to be sure it hasn’t made its way down to the UPJ or deeper before navigating a wire into the ureter and following that with a rigid scope. Or a flexible scope into the kidney. Delicate surgery, that.
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I can usually see stones at the UVJ or anywhere along the tract and size will probably determine is it needs i intervention , CT might be better To R/O septic stones as U/S isn’t great for acute pyelo.