“Kidney Stone Diagnosis: Tests, Symptoms & Treatment Options”

Diagnosis of kidney stone

“Kidney Stone Diagnosis: Tests, Symptoms & Treatment Options”Nephrolithiasis, or kidney stones, are diagnosed by looking at the patient’s medical history, doing a physical check, lab, and imaging studies tests. Here’s a step-by-step breakdown:

1. Medical History & Symptoms

Symptoms:Previous kidney stones Symptoms include severe flank pain (renal colic), discomfort extending to the groin, nausea and vomiting, blood in the urine (haematuria), frequent urination, or urinary urgency

Risk Factors:

*Dehydration

*High-sodium or high-protein diet
*Family history of kidney stones
*Conditions like hyperparathyroidism, gout, or UTI

2. Physical Examination

Tenderness in the flank or lower abdomen.
Checking for signs of infection (fever/chills if obstruction leads to pyelonephritis).

3. Imaging Studies (Key for Confirmation)
Non-Contrast CT Scan (Gold Standard):

Detects stone size, location, and obstruction.
Highly sensitive (>95%) for even small stones.

Ultrasound (USG):

Used in pregnant women or children to avoid radiation.
Less sensitive, but can identify hydronephrosis (swelling caused by blockage).

X-ray (KUB – Kidney, Ureter, Bladder):

Only detects calcium-based stones (~60% sensitivity).
Intravenous Pyelogram (IVP – Rarely used now):
Contrast dye helps visualize stones and obstruction.

4. Laboratory Tests
Urinalysis:

Hematuria (blood in urine) – present in ~85% of cases.
Stones (minerals oxide, uric acid, and so forth) can assist determine the sort of stone.

Urine pH:

Alkaline pH → Struvite stones (infection-related).
Acidic pH → Uric acid stones.
Urine Culture: If infection is suspected (e.g., struvite stones).

Blood Tests:

Serum creatinine & BUN (kidney function).
Calcium, uric acid, phosphate, electrolytes (metabolic workup).
When hypercalcemia exists, provide the thyroid hormone parathyroid hormone (PTH).

5. Stone Analysis (If Passed or Retrieved)

Chemical examination of a passing stone aids in preventative methods.

Differential Diagnosis (Conditions That Mimic Kidney Stones)

Pyelonephritis (a UTI with painful flanks and fever)
Appendicitis (right-sided pain)
Diverticulitis (left lower quadrant pain in elderly)
Musculoskeletal pain (e.g., muscle strain)
Ectopic fertilisation (in women of reproductive age)

Next Steps After Diagnosis

Pain management (NSAIDs, opioids if severe).
Hydration to help pass small stones (<5mm).
Medical expulsive therapy (e.g., tamsulosin for larger stones).

Surgical intervention (if stone is large, infected, or causing obstruction):

ESWL (Extracorporeal Shock Wave Lithotripsy)
Ureteroscopy with laser lithotripsy
Percutaneous nephrolithotomy (PCNL) for large stones (>2cm)