Could It Be Kidney Stones? Symptoms and Diagnosis - Internal Medicine

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Kidney stones, also known as renal calculi, are hard deposits made of minerals and salts that form inside the kidneys. They can cause significant pain and discomfort, particularly when they move into the ureters, the tubes connecting the kidneys to the bladder. The symptoms of kidney stones can often mimic other medical conditions, making diagnosis challenging. In your case, the symptoms you described, including severe pain in the left flank, could indeed be indicative of kidney stones, but they may also suggest other issues such as infections or even complications related to the kidneys.

When it comes to diagnosing kidney stones, a variety of tests are typically employed. These include urine tests, blood tests, and imaging studies such as ultrasound or CT scans. In your situation, the emergency department performed urine and blood tests, as well as an abdominal ultrasound. The absence of blood in the urine (hematuria) is a good sign, as it often indicates that stones are not present or that they are not causing significant irritation. However, the elevated white blood cell count could suggest an underlying infection or inflammation, which is something that needs to be addressed.

The ultrasound results indicating that the left kidney is slightly enlarged could be a sign of a blockage or other issues, such as hydronephrosis, where urine backs up into the kidney due to an obstruction. The inability to visualize the right kidney on the ultrasound could also be a concern, and further imaging may be necessary to determine its status.

Regarding your concern about the emergency department's handling of the situation, it's important to understand that emergency rooms often prioritize immediate life-threatening conditions. If the initial tests do not indicate a clear cause for the pain, they may recommend follow-up care with a specialist, such as a nephrologist or urologist, who can provide a more thorough evaluation and treatment plan.

As for your upcoming appointment with the nephrology clinic, it is crucial to communicate all the symptoms and concerns you have. The nephrologist may recommend additional imaging studies, such as a CT scan, which is more sensitive in detecting kidney stones compared to ultrasound. They may also consider other potential causes of your symptoms, including infections or anatomical abnormalities.

In terms of treatment, if kidney stones are confirmed, the management will depend on the size and type of the stones. Smaller stones may pass on their own with increased fluid intake, while larger stones may require medical intervention, such as lithotripsy (a procedure that uses shock waves to break up stones) or surgical removal.

In summary, while your symptoms could suggest kidney stones, it is essential to follow up with your healthcare provider for a comprehensive evaluation. The combination of your symptoms, imaging results, and laboratory findings will guide the diagnosis and treatment plan. Always remember that timely and appropriate medical care is crucial in managing conditions like kidney stones to prevent complications and alleviate pain.