The Role of Imaging in Management of Stone Disease

Children are at greater risk for deleterious effects of ionizing radiation than adults. Imaging strategies in children are therefore focused on obtaining the necessary clinical information using the minimum required dose of radiation. The appropriate imaging modality will depend upon the indication for evaluation. In the setting of suspected nephrolithiasis in children, ultrasound is generally regarded as the first-line modality. Computed tomography, especially with attention to dose modulation, may be useful in situations where the diagnosis is uncertain or ultrasound is unavailable. Cross-sectional imaging or adjunct imaging strategies such as abdominal radiography may be necessary in specific cases for preoperative planning. Following an acute presentation or surgical intervention, interval imaging should be timely and comparable to the initial imaging and should provide minimal additional radiation exposure. Surveillance imaging is generally performed using ultrasonography, although the appropriate interval for follow-up sonography remains undefined.