Kidney stone disease

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Author: Mikael Häggström [notes 1]

Kidney stone disease, also known as urolithiasis, is when a calculus (kidney stone) occurs in the urinary tract.[1]

Contents

Planning

Need for imaging

Imaging is indicated in cases of flank pain and hematuria.[2]

Choice of modality

  • Ultrasonography of the urinary system is the first-line imaging modality for patients <14 years of age and those who are pregnant. It is also the first-line investigation for thin (BMI <30) patients and there is a strong suspicion of kidney stone disease.[2]
  • Abdominal CT is recommended for older patients, as well as those who have higher BMI and/or less specific findings.[2]

Evaluation

Objectives of the evaluation include:[3]

  • Presence of stones within the urinary tract
  • Complications such as hydronephrosis (See: Hydronephrosis)
  • Measure the size of stones. Stones less than 5 mm (0.2 in) in diameter pass spontaneously in up to 98% of cases, while those measuring 5 to 10 mm (0.2 to 0.4 in) in diameter pass spontaneously in less than 53% of cases.[4]
  • Confirm any stone passage
  • Assess the stone burden

Report

  • Stone size(s) and location(s) along the urinary tract.
  • Hydronephrosis and its severity

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. . Kidney Stones in Adults (February 2013). Archived from the original on 11 May 2015. Retrieved on 22 May 2015.
  2. 2.0 2.1 2.2 Brisbane, Wayne; Bailey, Michael R.; Sorensen, Mathew D. (2016). "An overview of kidney stone imaging techniques ". Nature Reviews Urology 13 (11): 654–662. doi:10.1038/nrurol.2016.154. ISSN 1759-4812. 
  3. J Kevin Smith, Mark E Lockhart, Nicole W Berland and Philip J Kenney (2015-10-27). Urinary Calculi Imaging. Medscape.
  4. Gettman, MT; Segura, JW (2005). "Management of ureteric stones: Issues and controversies ". British Journal of Urology International 95 (Supplement 2): 85–93. doi:10.1111/j.1464-410X.2005.05206.x. PMID 15720341.