03 Case Study NephrolithiasisNephrolithiasis refers to the formation of stones (calculi) in the kidney. These stones can vary in size and may stay in the kidney or move into the urinary tract, potentially causing pain, obstruction, or infection. Clinical History: The patient is a [age]-year-old [male/female] presenting with sudden-onset, sharp, colicky flank pain that began [duration] ago. The pain radiates toward the lower abdomen or groin and is not relieved by rest or position changes.
Associated symptoms include:
Hematuria (blood in urine)
Nausea and/or vomiting
Urinary urgency or frequency
Figer
ЁЯУД Report Sample Line- Nephrolithiasis Shows a echogenic focus measuring approximately 5.6 mm in the renal calyx with posterior acoustic shadowing, suggestive of nephrolithiasis. No significant hydronephrosis noted."
Conclussion: ЁЯУЛ Nephrolithioasis Recommendation: Follow-up imaging (repeat ultrasound or CT KUB) in 1–2 weeks to assess stone progression or resolution.
Causes 1. Dehydration / Low Fluid Intake
Most common cause
Concentrated urine promotes crystal formation
2. Dietary Factors
High oxalate intake (spinach, nuts, tea, chocolate)
High sodium diet (increases calcium excretion)
Excess animal protein (raises uric acid and reduces citrate)
Low calcium intake (paradoxically increases stone risk)
3. Metabolic Disorders
Hypercalciuria (high urinary calcium)
Hyperoxaluria (high urinary oxalate)
Hyperuricosuria (high urinary uric acid)
Hypocitraturia (low citrate levels)
4. Medical Conditions
Gout
Hyperparathyroidism
Renal tubular acidosis
Inflammatory bowel disease or Crohn’s disease
Obesity and metabolic syndrome
5. Medications
Loop diuretics (e.g., furosemide)
Topiramate (antiepileptic)
Excess vitamin D or calcium supplements
Indinavir (HIV medication – forms drug-induced stones)
6. Urinary Stasis or Infection
Recurrent urinary tract infections (especially with Proteus species → struvite stones)
Obstruction or anatomical abnormalities causing urine retention
Symptoms
Severe, sudden onset flank pain (renal colic), often radiating to the groin or lower abdomen
Hematuria (blood in urine), visible or microscopic
Nausea and vomiting
Frequent urination or urgency
Dysuria (painful or burning sensation while urinating)
Cloudy or foul-smelling urine (suggestive of infection)
Fever and chills (if infection is present)
Restlessness due to severe pain
Diagnosis
Clinical history and physical examination focusing on characteristic flank pain and urinary symptoms
Urinalysis showing hematuria, crystals, or signs of infection
Blood tests including serum calcium, uric acid, and renal function
Imaging studies:
Non-contrast CT scan of the abdomen and pelvis – gold standard for stone detection
Ultrasound – useful especially in children and pregnant women; detects stones and hydronephrosis
Abdominal X-ray (KUB) – may detect radiopaque stones but less sensitive
Stone analysis (if passed or surgically removed) for composition and preventive management
Metabolic evaluation in recurrent cases to identify underlying causes
ЁЯУД Report Sample Line- Nephrolithiasis Shows a echogenic focus measuring approximately 5.6 mm in the renal calyx with posterior acoustic shadowing, suggestive of nephrolithiasis. No significant hydronephrosis noted.
Conclussion: ЁЯУЛ Nephrolithiasis Recommendation: Follow-up imaging (repeat ultrasound or CT KUB) in 1–2 weeks to assess stone progression or resolution.
Image Panel with Explanation
This is the explanation for Image 1.
1. Rt. upper calyx cal.
2. Calculus in upper calyx
3. Calculus in lower calyx
3. Calculus in renal pelvis
Topic Related MCQ Bilingual Quiz
Note: If you select English, answer all questions in English.
рдпрджि рдЖрдк рд╣िंрджी рдЪुрдирддे рд╣ैं, рддो рд╕рднी рдк्рд░рд╢्рди рд╣िंрджी рдоें рд╣рд▓ рдХрд░ें।
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