[Urolithiasis, CT and lithotripsy guidelines].
3% of the population experiences a flank pain during its lifetime. A flank pain is explained by calculus disease in more than 70% of the cases. Since the introduction of spiral CT and lithotripsy the work up of urolithiasis has changed. Many tests and treatment are available: KUB, IVP, ultrasound with color Doppler, CT and MR urography for diagnosis; lithotripsy, stenting or open surgery for treatment. The emergency practitioner, the radiologist and the urologist should answer three questions that will be reviewed in this paper: Is the acute flank pain caused by urolithiasis? Will calculus be spontaneously discharged? Is lithotripsy indicated?