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Haematuria is blood in the urine. This may be microscopic (visible only with a microscope) or macroscopic (visible to the naked eye). Either may be the sole manifestation of serious pathology. Use of investigations must be rationalised to ensure that bleeding due to renal tract tumours, urolithiasis or infections is diagnosed and treated promptly, while avoiding increasing morbidity, anxiety and cost by over-investigating low-risk patients. This article considers a number of strategies to achieve this balance, weighing up the merits of different techniques as first- and second-line tests in investigating haematuria. First, we discuss the detection of haematuria, concentrating in particular on the roles of dipstick testing and microscopy. The emphasis then moves to comparing the relevant radiological investigations. Each imaging modality is considered within a broader clinical context, and the protocol put forward for investigating haematuria is related to other published protocols. Various key pathologies are introduced and addressed throughout the review, and the final section summarises specific conditions and imaging findings. [ABSTRACT FROM AUTHOR]

A quiz concerning the diagnosis of a 75-year-old male patient who was referred with macroscopic hematuria is presented.

Haematuria can be microscopic or visible to the naked eye (macroscopic): both forms may be the sole manifestation of serious pathology. Clinicians must rationalize investigations to ensure that bleeding due to renal tract tumours, urolithiasis or infections is diagnosed and treated promptly; yet they must also avoid increasing morbidity, anxiety and cost by over-investigating low-risk patients. This article considers a number of strategies to achieve this balance, weighing up the merits of different techniques as first- and second-line tests in investigating haematuria. First, I discuss the detection of haematuria, concentrating in particular on the roles of dipstick testing and microscopy. My emphasis then moves to comparing the relevant radiological investigations. I include an extended section on CT urography, reflecting the increasing utility of this technique in urological practice. Each imaging modality is considered within a broader clinical context, and the protocol put forward for investigating haematuria is related to other published protocols. Various key pathologies are introduced and addressed throughout the review, and the final section summarizes specific conditions and imaging findings. [ABSTRACT FROM AUTHOR]