The Family Physician plays an important role in stone management, and it is important that primary care physicians know and understand guidelines for the diagnosis of stone disease and available treatment options. The following paper is intended to help the primary care physician diagnose stone disease and prescribe the right treatment based on that diagnosis. Diagnosing Stone Disease Physical Examination Physical Examination Diagnosing urolithiasis is relatively easy in most cases. Patients usually complain of intense pain in the abdomen or flank causing extreme discomfort. Fever may be present along with traces of blood in the urine or pain when urinating.
Costovertabral tenderness is present and usually elicited by tapping the patient's flanks.
A patient describing these symptoms is most probably suffering from renal colic caused by the passage of the stone through the urinary tract. If the patient has a history of stone disease in the family, or performs outdoor labor with limited fluid intake, the chances of stone disease are greater. In these cases, septicemia is a clear and present health threat and should be taken seriously. Laboratory Analysis Laboratory analysis will help the physician deduce the presence of a stone and the type of stone present. The following table shows normal values for three specific lab tests.