From the Guidelines
To diagnose kidney stones, you should seek medical evaluation if you experience symptoms like severe pain in your side or back, blood in urine, nausea, vomiting, or frequent urination, and your doctor will likely order several tests including urinalysis, blood tests, and imaging studies such as a CT scan, which is the gold standard 1. When diagnosing kidney stones, it's essential to consider the patient's symptoms, medical history, and risk factors. The diagnostic process typically involves a combination of physical examination, laboratory tests, and imaging studies.
- Urinalysis is used to check for blood or infection in the urine 1.
- Blood tests are used to assess kidney function and calcium levels 1.
- Imaging studies such as CT scan, ultrasound, or X-ray (KUB) can confirm the presence, size, and location of stones 1.
- A 24-hour urine collection may be requested to analyze urine chemistry and identify factors contributing to stone formation 1.
- If a stone is passed, it should be collected for laboratory analysis to determine its composition, which helps guide prevention strategies 1. The choice of imaging study depends on the clinical presentation and the suspected location of the stone.
- CT abdomen and pelvis without IV contrast is particularly useful when obstructive urolithiasis is a primary concern 1.
- Ultrasound is a useful initial imaging test, especially in patients with renal colic, but it may not detect small stones or stones in certain locations 1. Early diagnosis is crucial because kidney stones can cause complications like urinary tract infections or kidney damage if left untreated 1.
- The diagnostic process is relatively straightforward but requires medical expertise to interpret results correctly and develop an appropriate treatment plan 1.
- It's also important to consider the patient's overall health and medical history when developing a treatment plan, as certain medical conditions can increase the risk of kidney stones 1.
From the Research
Symptoms of Kidney Stones
- Acute abdominal or flank pain
- Nausea
- Emesis 2
Diagnosis of Kidney Stones
- Ultrasonography can be used as the initial imaging method for patients with suspected nephrolithiasis
- Computed tomography (CT) can also be used, but it is associated with higher cumulative radiation exposure compared to ultrasonography 3
- The choice of imaging method does not significantly affect the incidence of high-risk diagnoses with complications, serious adverse events, pain scores, return emergency department visits, or hospitalizations 3
Important Considerations
- Nephrolithiasis is a common affliction, affecting approximately 10% of adults 2
- The risk of nephrolithiasis is increased in certain general surgical conditions, including inflammatory bowel disease, hyperparathyroidism, and short gut 2
- Nephrolithiasis may be induced as a result of general surgical interventions, including gastric bypass and bowel resection with ileostomy 2
Note: The study 4 is not relevant to the diagnosis of kidney stones.