Diagnosis of Kidney Stones Health Care Resources

Diagnosis of Kidney Stones

Diagnosis of kidney stone is suspected clinically when there is pain in abdomen in the area where the kidneys are located. Nature of pain is also suggestive of the disease, such as spasmodic colicky type of pain which comes in waves and goes away. When there is pain in the back, it indicates that the kidney stone may have obstructed the outflow of urine from kidney.

The diagnosis of kidney stone is based on imaging studies. There are several other tests, which may be useful in finding out the cause of the kidney stone. For diagnosis of kidney stones X-ray, ultrasound, CT scan (computed tomography) etc. are done.

Conventional/traditional X-rays can detect most kidney stones, as they have high concentration of calcium (approximately 10% of kidney stones can not be detected by normal X-ray due to low calcium content), which make them radio-opaque. Usually KUB (kidneys, ureters and bladder) X-ray is done. This may be followed by intravenous urogram (IVU) where 50 ml of special dye is injected into the blood which is than excreted by kidneys and relative density outlines the stone, repeat X-ray. The same can be achieved by retrograde pyelogram, where special dye is injected directly into the opening of ureters by an urologist.

Many doctors recommend ultrasound (US) as primary diagnostic tool for kidney stones and reserve CT for suspected but not detected after US. Ultrasound can detect kidney stones as well as hydronephrosis, which is swelling of kidney due to urine outflow obstruction in kidney, mostly due to stones. Use of ultrasound is also safe during pregnancy and there is no radiation hazard with US, unlike CT. US is also much cheaper than CT.

Computed tomography is the gold standard for diagnosis of kidney stones. When every other diagnostic method (ultrasound, X-ray, IVU etc.) fails, CT can diagnose kidney stones. After detection of kidney stone with CT, a routine X-ray (KUB) is recommended for exact size, shape and to determine surgical approach. The drawbacks of use of CT includes, high cost (in compare to US or X-ray), radiation hazards and for radiation hazard CT is not recommended during pregnancy.

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