The superior imaging of computerized tomography comes with ionizing radiation exposure, which is a point of increasing concern as the long-term effects of medical radiation have yet to be defined. Renal US has been used in the evaluation of renal calculi for many years. Although attractive as a radiation-free modality, one of its greatest drawbacks has been inaccuracy in estimating stone size.
In this study Dunmire et al found that measuring the shadow width rather than the stone width more accurately estimated the true stone size. These findings have immediate clinical utility and may readily be applied to practice. Importantly such research is most welcome in the field of stone management as it may permit greater use of radiation-free imaging in the evaluation of stone forming patients. Given the recurrent nature of the disease, minimizing exposure to medical radiation may ultimately confer long-term benefits to our patients.