Kidney stone disease
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
File:Algorithm for kidney stone disease.png
Algorithm for kidney stone disease, developed in the US.[3]
- Ultrasonography of kidney stone disease 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] In the algorithm at right, hydronephrosis may count as a diagnostic finding of urolithiasis.
- CT of kidney stone disease is recommended for older patients, as well as those who have higher BMI and/or less specific findings.[2]
Evaluation
- Ultrasonography of renal stone located at the pyeloureteric junction.jpg
Renal ultrasonograph of a stone located at the pyeloureteric junction with accompanying hydronephrosis.
- 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 window.
Objectives of the evaluation include:[4]
- 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.[5]
- Confirm any stone passage
- Assess the stone burden
Report
- Stone size(s) and location(s) along the urinary tract.
- Hydronephrosis and its severity
Notes
- ↑ 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
- ↑ . Kidney Stones in Adults (February 2013). Archived from the original on 11 May 2015. Retrieved on 22 May 2015.
- ↑ 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:. ISSN 1759-4812.
- ↑ Brisbane, Wayne; Bailey, Michael R.; Sorensen, Mathew D. (2016). "An overview of kidney stone imaging techniques ". Nature Reviews Urology 13 (11): 654–662. doi:. ISSN 1759-4812.
- ↑ J Kevin Smith, Mark E Lockhart, Nicole W Berland and Philip J Kenney (2015-10-27). Urinary Calculi Imaging. Medscape.
- ↑ Gettman, MT; Segura, JW (2005). "Management of ureteric stones: Issues and controversies ". British Journal of Urology International 95 (Supplement 2): 85–93. doi:. PMID 15720341.
