How is it Diagnosed?
Kidney and ureteral stones, also known as urolithiasis, are diagnosed based on a
combination of clinical presentation and imaging studies. Patients typically present with
sudden onset of severe flank pain, radiating to the groin, often accompanied by nausea,
vomiting, hematuria (blood in urine), and urinary urgency or frequency.
Initial assessment includes a detailed history, physical examination, and urinalysis,
which may reveal microscopic or gross hematuria and signs of infection (e.g., pyuria).
Blood tests help assess kidney function (serum creatinine, BUN) and look for infection
or metabolic abnormalities (calcium, uric acid).
Imaging plays a pivotal role. The non-contrast CT scan of the abdomen and pelvis is the
gold standard, providing high sensitivity and specificity for detecting stones, their size,
location, and degree of obstruction. Ultrasound is often used in children, pregnant
women, and in follow-up cases due to its safety and non-radiative nature, though it
may miss smaller stones.
X-rays (KUB – kidney, ureter, bladder) may detect radio-opaque stones, especially
calcium-based ones, but are less reliable. Intravenous pyelogram (IVP) is rarely used
now but can help in anatomical assessment. Once confirmed, the type of stone is often
inferred based on imaging and further confirmed via stone analysis after spontaneous
passage or surgical removal.
Proper diagnosis enables tailored treatment—hydration, pain relief, medical expulsive
therapy, or surgical intervention like lithotripsy or ureteroscopy.