Renal colic

Most urinary tract stones occur in the upper urinary tract.

Their composition varies widely depending upon metabolic alterations, geography and presence of infection.

Their size varies from gravel to staghorn calculi. Some are the result of inborn errors of metabolism - gout, cystinuria, primary hyperoxaluria.

Most are radio-opaque. small stones arising in the kidney are more likely to pass into the ureter where they may cause severe colicky pain; large stones may be asymptomatic because of their immobility superimposed infection may result from mucosal trauma and/or obstruction.

Usual presentation of renal/ureteric stones is as an acute episode with severe pain (1) - renal colic or ureteric colic

• although some stones are picked up incidentally during imaging or may present as a history of infection the initial diagnosis is made by taking a clinical history and examination and carrying out imaging; initial management is with painkillers and treatment of any infection

Ureteric colic is caused by the passage of solid material along the ureter, most commonly a stone that has originated in the kidney.

Reference:

• NICE (December 2018).Renal and ureteric stones: assessment and management (NG118)