CT scans dominate kidney stone diagnosis as ultrasound fades in US ERs

Kidney stones are landing more patients in the hospital, and emergency departments are increasingly reaching for CT scanners to confirm the diagnosis. A large cross-sectional study using data from over 42,000 US hospitals found that CT use for nephrolithiasis surged from 73.8% in 2016 to 89.8% in 2024—while ultrasound use slipped from 5.8% to just 3.8% over the same period.

Beyond imaging, the study also captured notable shifts in how kidney stone patients are being managed. Opioid use in the ED dropped from 61.5% to 49.7%, with ketorolac emerging as the go-to painkiller. Tamsulosin remained the top discharge medication, and surgical interventions like cystoscopy with stent placement more than doubled.

By the Numbers:

• CT use: 73.8% → 89.8%
• Ultrasound use: 5.8% → 3.8%
• Hospital admissions: 8.9% → 12.7%
• ED opioid administration: 61.5% → 49.7%
• Discharge opioid prescriptions: 8.8% → 14.7%
• Cystoscopy with stent placement: 3.0% → 6.8%

Why it matters: These trends point to a growing reliance on CT imaging and inpatient care for a condition that's increasingly common. Understanding these shifts can help drive quality improvement efforts—especially around smarter imaging decisions and reducing unnecessary radiation exposure.