Ultrasound in Emergency Medicine Incidental Renal Cysts found by Point-of-Care Ultrasound: A Retrospective Chart Review

Background Incidental findings are unrelated to a patient's complaint, found on diagnostic imaging, such as point-of-care ultrasound (POCUS). Incidental findings represent potential harms to patients and may lead to increased patient anxiety and healthcare costs related to downstream testing and surveillance. Objectives In this study, we aimed to calculate the rate of incidental renal cysts found by POCUS. Further, we hoped to describe how ED physicians relay the findings to patients. Lastly, we hoped to examine if patients suffered harms in the 12 months following identification of an incidental renal cyst. Methods From our single-center, academic ED, we reviewed renal POCUS images from 1,000 consecutive adult ED patients to determine if there was a renal cyst. Next, we performed manual chart review to determine if patients were informed of the incidental renal cyst or suffered any patient harms. Results We found the prevalence of renal cysts to be 6.5% (95% CI: 4.9% to 8.4%). Those with cysts were more likely to be older compared to those without (63 ± 14 vs. 49 ± 15 years of age). Only 8% of patients had evidence that they were informed of their incidental renal cyst. No patients received a biopsy or were diagnosed with renal cell carcinoma or polycystic kidney disease. Conclusion Incidental renal cysts are common and are more likely to be found in older adults. In our study, physicians infrequently informed patients of their incidental finding.