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Ureteric stone — MCCQE Part 1 MCQ

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ModerateBlood in UrineUreteric stoneMCCQE Part 1

A 36-year-old man presents with sudden severe left flank pain radiating to the groin and microscopic haematuria. He is afebrile, BP 132/82 mmHg, creatinine is normal, and pain improves with ketorolac. He has no previous stones. What is the most appropriate investigation?

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Correct answer: D — Low-dose non-contrast CT of the kidneys, ureters, and bladder

Renal colic in a non-pregnant adult is usually confirmed with low-dose non-contrast CT KUB when imaging is required, especially with a first episode. Intravenous pyelogram is largely superseded. Colonoscopy and PSA do not address acute flank-to-groin pain with haematuria. MRI pelvis is not the standard first-line test for suspected ureteric stone.

Reference: Canadian Urological Association ureteral calculi guideline