A Radiology Pathway
In NHS Lothian, GPs have Direct Access to CT KUB for the expedited urgent investigation of symptomatic patients with unilateral loin pain and a suspected diagnosis of acute renal colic. The aim of this service is to aid management by providing an early diagnosis for symptomatic patients, who might otherwise need to be referred as an emergency. Eligible patients will be scanned as soon as practicably possible. This service is not for the investigation of patients who have more non-specific symptoms.
Contacting Radiology
If GPs have a query about a specific radiological report, they should email the reporting Radiologist or Radiographer directly. Locum / Sessional GPs should copy in the practice Clinical inbox so that any reply can be actioned on by the patient’s practice. If the query is urgent or the reporter is not findable on the email system, then please contact the Duty Radiologist at the relevant site as detailed below.
By Phone
PLEASE NOTE THESE NUMBERS ARE FOR PROFESSIONAL USE ONLY, THEY ARE NOT FOR PATIENTS
If GPs have any specific queries they can contact the Duty Radiologist for advice on the numbers below. (Patient department contact numbers can be found in the Plain X-rays & Ultrasound section).
- WGH: GP contact number for Duty Radiologist 0131 537 2315
- SJH: GP contact number for Duty Radiologist 01506 524 352
- RIE: GP contact number for Duty Radiologist 0131 242 3572
- DCN: GP contact number for Duty Radiologist 0131 312 0119
- RHCYP: GP contact number for Duty Radiologist 0131 312 0120
By Email
PLEASE NOTE THESE EMAIL CONTACTS ARE FOR PROFESSIONAL USE ONLY, THEY ARE NOT FOR PATIENTS
The email addresses below can be used for administrative enquiries/ expediting reports/ changing appointments etc, but not for specific individual purely clinical questions.
- WGH: wgh.radiology@nhs.scot
- WGH Mammography: wgh.mammography@nhs.scot
- RIE: radiology.rie@nhs.scot
- SJH: sjh.radiology@nhs.scot
UPDATED JK, SG & JB DEC 2025
Who To Refer:
CT KUB can be requested for patients:
- Who have symptoms of unilateral renal colic
- Who do not require admission
- Who are male (any age), or female >40 years
Microscopic haematuria is not a prerequisite for CT KUB. A good history is.
For all Radiology requests: Referrers accept responsibility for dealing with the result(s) and informing the patient as necessary.
Who Not to Refer:
- Patients whose pain is uncontrolled with diclofenac, paracetamol and dihydrocodeine – these patients should be referred as an emergency via Flow Centre; or if proven stones and under follow up with Urology, refer to on-call Urology team.
- CT KUB is not indicated for vague symptoms, general abdominal pain, or pain not consistent with stone disease.
- Female patients <40 years. Women <40 yrs with acute loin pain are much less likely to have stones, and more likely to have other pathology (e.g. pyelonephritis, ovarian cyst), so should be referred for US renal tract and pelvis as per the guidance under Urology Loin Pain
- Patients with a known history of stones. Patients should be referred back to the Scottish Lithotriptor Centre urgently (SCI Gateway referral to urology), who will arrange imaging tailored to the patient (CT KUB is not routinely necessary for these patients, who are at risk of a significant cumulative radiation dose as a result of repeated stone episodes).
How To Refer:
Via SCI Gateway, please mark requests as urgent:
- RIE > Clinical Radiology > LI Radiology CT (KUB only)
- SJH > Clinical Radiology > LI Radiology CT (KUB only)
- WGH > Clinical Radiology > LI Radiology CT (KUB only)
Information required for the SCI Gateway referral:
- Reasons for request (free text)
- Side, duration, and severity of symptoms
- CT Practicality and Safety questions: LMP / DM? / Latex Allergy? / Impaired Renal Function? (please provide details in reasons for request box) / Patient weight >20 stones
- Details of previous imaging
MRI / CT Scanning, Contrast and Kidney Function
When referring along a pathway for CT or MRI, it is helpful if a recent eGFR (within the past six months) is available. This is especially important for patients who:
- Have known kidney disease or previous kidney transplant AND / OR
- Are being seen / waiting to be seen by Renal Physician or Urologist AND / OR
- Have symptoms of acute illness likely to cause AKI (diarrhoea; vomiting; fever; hypovolaemia; infection or difficulty passing urine
For patients with a reduced eGFR please make sure this is noted on the SCI Gateway referral. Please note that for some pathways, bloods are required more recently than the six months noted above.
Patients who do not have an eGFR within the past six months available to the Radiology appointment, particularly those at risk for kidney impairment, may not be able to have their investigation carried out until up to date bloods have been done.
