Aeromedical disposition dilemma: Renal calculi

Abstract

Renal colic is a condition which causes acute pain of variable intensity. At times, this makes the sufferer visibly powerless and prevents him from performing any skilled task satisfactorily. The most common cause of the symptom is related to a calculus, which is moving inside the ureter inducing ureteral spasm. A military aircrew is declared unfit to fly in case he/she is detected to have renal calculi. At present, with the newer and advanced investigation techniques, the detection of even small renal calculi is possible. This has led to an increase in clinical data. Since the clinical outcome of renal calculi is unpredictable, aeromedical disposition becomes a challenging task for such cases. The paper brings a review of existing disposition guidelines for cases of renal calculi both in the military and civil aviation in different parts of the globe. An attempt is also made to present an approach toward aeromedical certification and surveillance in the form of a proposed decision algorithm to be used by the flight surgeon.