Diagnosis can be done on the basis of the clinical features of the person having a renal colic.
On examination, kidney cannot be palpated unless hydronephrosis (swelling of kidney) has developed.
Abdominal rigidity will be felt at the time of colicky pain. Tenderness can be elicited either in the renal angle or during bimanual palpation.
It is important to note that quite a number of kidney stones are asymptomatic. These are mainly phosphate stones. Diagnosis can be confirmed through certain investigations.
Investigations For Kidney Stones
Radiography
Radiographs of kidneys, ureters and the bladder are taken.
- When a renal calculus is branched, there is no doubt concerning the shadow it casts. X-rays usually confirms 90% of the renal stones except the pure uric acid stones.
- When a stone is found, exposures are made during full inspiration and full expiration to see whether the stone moves slightly with the kidney during respiration. This is essential to exclude other conditions which will show similar type of shadow.
- A renal stone will be seen to super imposed on the bodies of the lumber vertebras.
Excretory pyelography
It is of value in confirming that the opacity is intra-renal.
- In determining in which part of the kidney the stone is situated and in revealing the function of the other kidney.
- If it has produced obstructive features or not.
- Presence of non-opaque stone which can be visualized by filling defect.
Cystoscopy : A urethral stricture or prostatic obstruction will be revealed by instrumental examination.