Differential Diagnosis for a 0.3 cm Non-Obstructing Right Renal Calculus
- Single Most Likely Diagnosis
- Asymptomatic renal calculus: This is the most likely diagnosis given the small size of the calculus and the fact that it is non-obstructing. Many people have small renal calculi that do not cause symptoms and are only discovered incidentally.
- Other Likely Diagnoses
- Recurrent urinary tract infections (UTIs): The presence of a renal calculus can increase the risk of UTIs, even if the calculus is not currently causing an obstruction.
- Nephrolithiasis with potential for future obstruction: Although the calculus is currently non-obstructing, there is a risk that it could grow or move and cause an obstruction in the future.
- Renal colic: If the calculus were to move or become obstructing, it could cause severe pain, known as renal colic.
- Do Not Miss Diagnoses
- Ureteropelvic junction (UPJ) obstruction: Although less likely, a non-obstructing renal calculus could be a sign of an underlying UPJ obstruction, which would require further evaluation and potentially surgical intervention.
- Xanthogranulomatous pyelonephritis: This is a rare but serious condition that can cause destruction of the kidney and is often associated with long-standing urinary tract obstruction.
- Renal cell carcinoma: Although very unlikely, a renal mass could be mistaken for a calculus on CT, and it is essential to consider this possibility to avoid missing a potentially life-threatening diagnosis.
- Rare Diagnoses
- Medullary sponge kidney: This is a rare congenital disorder that can increase the risk of developing renal calculi.
- Primary hyperparathyroidism: This condition can increase the risk of developing renal calculi due to hypercalcemia.
- Cystinuria: This is a rare genetic disorder that can increase the risk of developing cystine renal calculi.