Radiological Investigation of Acute Renal Colic: A Two-Cycle Clinical Audit

Abstract Renal colic is a common urological emergency that requires a noncontrast computed tomography of the kidneys, ureters, and bladder (CT KUB) as the investigation of choice. This two-cycle audit was conducted at Manchester Royal Infirmary; a tertiary hospital in the United Kingdom. It evaluates the appropriateness of CT KUB imaging for acute renal colic, focusing on scan timing, diagnostic yield, and request adequacy in line with national guidelines. We performed a retrospective review of patients referred from the accident and emergency department for suspected renal colic. The first cycle was conducted in September to October 2022 and the second in August 2023. The intervention included disseminating the findings and designing an educational program. Statistical analysis was performed using SPSS version 30.0. Continuous variables were compared using independent t-tests, and categorical variables using chi-square tests. A p-value of < 0.05 was considered statistically significant. A total of 153 patients were included (first cycle: 77; second cycle: 76). Following the intervention, the mean time from presentation to CT KUB report decreased significantly from 14.7 ± 9.5 to 8.2 ± 5.1 hours (p < 0.001). The proportion of scans reported within 24 hours also increased from 92.2 to 100% (p = 0.007). Documentation of a sufficient history improved from 76.6 to 89.5% (p = 0.034). Additionally, reports of nonspecific abdominal pain decreased from 9.1 to 0% (p = 0.007). Targeted educational interventions improved CT KUB timeliness, request quality, and adherence to national guidelines. These results confirm the value of structured clinical pathways and cross-departmental collaboration in optimizing the investigation of suspected renal colic.