Kidney stone disease - Revision history

Mikael Häggström: Distinguished

2018-11-08T11:17:57Z

Distinguished

Mikael Häggström: /* Evaluation */ Moved to CT page

2018-11-08T10:16:41Z

Evaluation: Moved to CT page

Mikael Häggström: Merged from Urolithiasis

2018-11-08T09:17:17Z

Merged from Urolithiasis

Mikael Häggström: Templated

2018-11-08T09:10:36Z

Templated

Mikael Häggström at 15:48, 6 November 2018

2018-11-06T15:48:05Z

Mikael Häggström at 08:47, 26 September 2018

2018-09-26T08:47:41Z

Mikael Häggström: /* Evaluation */ Specified

2018-09-03T19:35:18Z

Evaluation: Specified

Mikael Häggström: /* Evaluation */ Expanded

2018-09-03T19:34:32Z

Evaluation: Expanded

Mikael Häggström: /* Evaluation */ +Purposes

2018-09-03T19:31:21Z

Evaluation: +Purposes

Mikael Häggström: /* Report */ Specified

2018-09-03T19:18:08Z

Report: Specified

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 '''Kidney stone disease''', also known as '''urolithiasis''', is when a calculus (kidney stone) occurs in the [[urinary tract]].<ref name=NIH2013>{{cite web|title=Kidney Stones in Adults|url=http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/kidney-stones-in-adults/Pages/facts.aspx|accessdate=22 May 2015|date=February 2013|deadurl=no|archiveurl=https://web.archive.org/web/20150511192215/http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/kidney-stones-in-adults/Pages/facts.aspx|archivedate=11 May 2015|df=dmy-all}}</ref>
-==Planning==
+==Acute disease - planning==
 {{Kidney stone disease - need and choice of modality}}
-==Evaluation==
+==Recurrent==
-<gallery>
+See '''[[CT in recurrent kidney stone disease]]'''.
 {{Bottom}}

@@ Line 11: / Line 11: @@
 ==Evaluation==
 <gallery>
-File:3mmstone.png|[[Transverse plane|Axial]] [[X-ray computed tomography|CT scan]] of abdomen without contrast, showing a 3-mm stone (marked by an arrow) in the left proximal [[ureter]]
 File:Ultrasonography of renal stone located at the pyeloureteric junction.jpg|[[Renal ultrasonograph]] of a stone located at the pyeloureteric junction with accompanying hydronephrosis.
-File:CT measurement of kidney stone in soft tissue and bone window.jpg|Measurement of a 5.6 mm large kidney stone in soft tissue window (at left, with width of 400 HU, and center at 50 HU) versus skeletal window (right, W1800,C400). 145 HU is regarded as an appropriate cutoff to distinguish a stone from surrounding tissue.<ref name="LidénThunberg2015">{{cite journal|last1=Lidén|first1=Mats|last2=Thunberg|first2=Per|last3=Broxvall|first3=Mathias|last4=Geijer|first4=Håkan|title=Two- and three-dimensional CT measurements of urinary calculi length and width: a comparative study|journal=Acta Radiologica|volume=56|issue=4|year=2015|pages=487–492|issn=0284-1851|doi=10.1177/0284185114528490}}</ref>
 </gallery>
 ==Report==

@@ Line 13: / Line 13: @@
 File:3mmstone.png|[[Transverse plane|Axial]] [[X-ray computed tomography|CT scan]] of abdomen without contrast, showing a 3-mm stone (marked by an arrow) in the left proximal [[ureter]]
 File:Ultrasonography of renal stone located at the pyeloureteric junction.jpg|[[Renal ultrasonograph]] of a stone located at the pyeloureteric junction with accompanying hydronephrosis.
-File:CT measurement of kidney stone in soft tissue and bone window.jpg|Measurement of a 5.6 mm large kidney stone in soft tissue versus skeletal [[CT_scan#Process|CT window]].
+File:CT measurement of kidney stone in soft tissue and bone window.jpg|Measurement of a 5.6 mm large kidney stone in soft tissue window (at left, with width of 400 HU, and center at 50 HU) versus skeletal window (right, W1800,C400). 145 HU is regarded as an appropriate cutoff to distinguish a stone from surrounding tissue.<ref name="LidénThunberg2015">{{cite journal|last1=Lidén|first1=Mats|last2=Thunberg|first2=Per|last3=Broxvall|first3=Mathias|last4=Geijer|first4=Håkan|title=Two- and three-dimensional CT measurements of urinary calculi length and width: a comparative study|journal=Acta Radiologica|volume=56|issue=4|year=2015|pages=487–492|issn=0284-1851|doi=10.1177/0284185114528490}}</ref>
 </gallery>
@@ Line 19: / Line 19: @@
 *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.<ref name=Gettman2005>{{cite journal|last=Gettman|first=MT|last2=Segura|first2=JW|title=Management of ureteric stones: Issues and controversies|journal=British Journal of Urology International|volume=95|issue=Supplement 2|pages=85–93|year=2005|pmid=15720341|doi=10.1111/j.1464-410X.2005.05206.x}}</ref>
+*Measure the size of stones. Proper sizing of a stone is important at around 5 mm and above, since smaller stones generally pass spontaneously.<ref group="notes">Ureteric stones less than 5 mm in diameter pass spontaneously in up to 98% of cases, while those measuring 5 to 10 in diameter pass spontaneously in less than 53% of cases.<br> - {{cite journal|last=Gettman|first=MT|last2=Segura|first2=JW|title=Management of ureteric stones: Issues and controversies|journal=British Journal of Urology International|volume=95|issue=Supplement 2|pages=85–93|year=2005|pmid=15720341|doi=10.1111/j.1464-410X.2005.05206.x}}</ref> Sizing of larger stones is also important in order to decide which treatment to choose.<ref group="notes">Small proximal ureteral calculi of less than 10 mm are best treated with shock wave lithotripsy and ureteroscopy, while those larger than 10 mm are best treated with flexible ureteroscopy combined with holmium laser lithotripsy.
 *Confirm any stone passage
 *Assess the stone burden

@@ Line 7: / Line 7: @@
 ==Planning==
-===Need for imaging===
+{{Kidney stone disease - need and choice of modality}}
 ==Evaluation==

@@ Line 10: / Line 10: @@
 Imaging is indicated in cases of flank pain and hematuria.<ref name="BrisbaneBailey2016">{{cite journal|last1=Brisbane|first1=Wayne|last2=Bailey|first2=Michael R.|last3=Sorensen|first3=Mathew D.|title=An overview of kidney stone imaging techniques|journal=Nature Reviews Urology|volume=13|issue=11|year=2016|pages=654–662|issn=1759-4812|doi=10.1038/nrurol.2016.154}}</ref>
-===Choice of exam===
+===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.<ref name="BrisbaneBailey2016"/>
 *'''[[Abdominal CT]]''' is recommended for older patients, as well as those who have higher BMI and/or less specific findings.<ref name="BrisbaneBailey2016"/>

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-{{Authors
+{{Top
 |author1=[[User:Mikael Häggström|Mikael Häggström]]
 |author2=
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 *Hydronephrosis and its severity
-==References==
+{{Bottom}}

@@ Line 21: / Line 21: @@
 </gallery>
-An evaluation should also be done about presence of hydronephrosis, and its severity. ''See: [[Hydronephrosis]]''
+The evaluation should focus on:<ref>{{cite web|url=https://emedicine.medscape.com/article/381993-overview|title=Urinary Calculi Imaging|author=J Kevin Smith, Mark E Lockhart, Nicole W Berland and Philip J Kenney|website=Medscape|date=2015-10-27}}</ref>
 ==Report==

@@ Line 24: / Line 24: @@
 ==Report==
-*Stone size(s) and location.
+*Stone size(s) and location(s) along the urinary tract.
 *Hydronephrosis and its severity
 ==References==
 {{reflist}}