How is it Diagnosed?
The diagnosis of kidney stones is aimed at confirming the presence of calculi in the
renal pelvis or calyces and assessing their impact on renal function and patient
symptoms. The process starts with a clinical evaluation; typical symptoms include flank
pain, hematuria, nausea, and urinary changes.
Urinalysis is an essential initial test, often revealing hematuria (blood in urine), crystals,
and possible signs of urinary tract infection. Blood tests evaluate kidney function
(creatinine, urea) and help detect metabolic disorders (elevated calcium, uric acid) that
may predispose to stone formation.
The most definitive diagnostic modality is a non-contrast spiral CT scan of the abdomen
and pelvis, which identifies stone location, size, and degree of obstruction. It is highly
sensitive and can detect even small stones. In special populations such as pregnant
women or those who require repeat imaging, renal ultrasound is the preferred tool due
to its safety, though it may miss smaller or non-obstructive stones.
X-ray KUB can be useful for follow-up of radiopaque stones, while IVP is now rarely
used. Stone analysis, if the stone is passed or surgically retrieved, confirms composition
(calcium oxalate, uric acid, struvite, cystine) and guides prevention strategies.
Accurate diagnosis informs the management plan—ranging from conservative treatment
with fluids and painkillers to active interventions like extracorporeal shock wave
lithotripsy (ESWL) or ureteroscopy.