1. Complain: Uteric / renal colic
X-Ray KUB : ? Stone
? Phlebolith
No RO calculus
Gas / fetal matter
USG KUB: Mild hydronephrosis
Ureter obscured by gas/fecal matter.
Urinary bladder empty.
Expense: Rs. 950/- to 1150 (with plate)/-
End Result: Diagnostic dilema
No size / location of stone
No surgical roadmap.
X-RAY HOUSE, ANAND

2. IVP
Sometimes difficult to find out radiolucent stone / uretic stricture / external compression.
If no function / delayed function, then it is difficult to find out cause of obstruction.
Again Expense: Rs. 2000/-
???? SOLUTION
X-RAY HOUSE, ANAND

3. Plain CT KUB -introductory offer…. Rs. 2000/-
Advantages:
1. Can pick up all the stones-radio-opaque & radio-lucent.
2. No obscuration by gas / fecal matter.
3. Will give precise location & size of stone.
4. Will give operative roadmap.
5. Will provide density of the stone which is helpful for deciding the type of stone.
6. Will give exact no. and size of stones.
7. Will give information about ureteric tortucity, kinking external compression.
8. Will also provide information regarding other abdominal pathology.
If you want to know about renal function then go for-
CT IVP (+ Rs. 2000/- more)
X-RAY HOUSE, ANAND

4. Limitations of USG Limitations of X-Ray
Gas / Fecal Matter
No full bladder
Compared to CT KUB, only 54 % sensitivity in identifying calculi –Less Specificity.
Operator dependent
There will be difference in size and no. of stones even if USG done on the same day by different radiologists.
No diagrammatic representation.
Limitations of X-Ray
Radiolucent stones are not visualized
Even radioopaque stones are obscured by bones, gas & fecal matter.
X-RAY HOUSE, ANAND