Diagnosis of Renal Lithiasis: Imaging Tests and Urine Analysis for Nephritic Colic Pain

Dear colleagues, renal lithiasis, also known as kidney stones, is a prevalent condition affecting a significant portion of the population. Accurate and timely renal lithiasis diagnosis is crucial for the effective management of this pathology, which can present acute symptoms such as nephritic colic pain. In this article, we will explore the most effective diagnostic tools, focusing on imaging tests and urine analysis.

Diving Deeper into Diagnosis

The diagnosis of renal lithiasis begins with a detailed clinical evaluation, followed by laboratory tests and imaging studies. Urine analysis is an essential tool that can reveal the presence of urine crystals, microscopic hematuria, and other abnormalities suggesting the presence of stones. However, its specificity is limited, as many conditions can cause hematuria [31030828].

Regarding imaging tests, CT urogram without contrast is the gold standard for detecting kidney stones due to its high sensitivity and specificity [22164398]. However, in pediatric and pregnant patients, renal ultrasound is preferred to avoid radiation exposure [32068597]. Color Doppler ultrasound can enhance the detection of ureteral stones, reducing the need for CT in some cases [25254610].

Additionally, the patient's medical history, including a history of urolithiasis, can guide the choice of the most appropriate imaging modality. In cases where the diagnosis is unclear, a contrast-enhanced CT may be useful to rule out alternative diagnoses [29675722].

Conclusions

The diagnosis of renal lithiasis requires a multidisciplinary approach that combines clinical evaluation, urine analysis, and imaging tests. The choice of imaging modality should be individualized, considering factors such as the patient's age, pregnancy status, and medical history. CT urogram remains the most accurate tool, but renal ultrasound offers a safe alternative in specific populations. An accurate diagnosis not only facilitates appropriate treatment but also helps prevent complications and recurrences.

Referencias

• [1] Hematuria
• [2] Renal calculi: emergency department diagnosis and treatment
• [3] Evaluation of a child with suspected nephrolithiasis
• [4] Value of Color Doppler ultrasound, kub and urinalysis in diagnosis of renal colic due to ureteral stones
• [5] Contrast-enhanced or noncontrast CT for renal colic: utilizing urinalysis and patient history of urolithiasis to decide

Created 5/1/2025