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Urolithiasis
Katherine To'o, MD; Aya Kamaya, MD, FSRU, FSAR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Ureterovesicular junction (UVJ); ureteropelvic junction (UPJ); IV pyelogram (IVP)
              • Synonyms

                • Urinary tract stone, urinary calculous disease, nephrolithiasis, ureterolithiasis, vesicolithiasis
              • Definitions

                • Macroscopic concretions of crystals in urinary system ± mixed with proteins

              IMAGING

              • General Features

                • Ultrasonographic Findings

                  • Radiographic Findings

                    • CT Findings

                      • MR Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Liu N et al: Sonographic twinkling artifact for diagnosis of acute ureteral calculus. World J Urol. 38(2):489-95, 2020
                                          2. Miller N et al: Evaluation and medical management of urinary lithiasis. In Partin et al: Campbell-Walsh Urology. 12th ed. Elsevier. 2036-68, 2020
                                          3. Nourian A et al: Dual-energy CT for urinary stone evaluation. Curr Urol Rep. 22(1):1, 2020
                                          4. Pearle M et al: Urinary Lithiasis: etiology, epidemiology, and pathogenesis. In Partin A et al: Campbell-Walsh Urology. 12th ed. Elsevier. 2005-35, 2020
                                          5. Rule AD et al: Management of kidney stones in 2020. JAMA. 323(19):1961-2, 2020
                                          6. Masch WR et al: Clinical effectiveness of prospectively reported sonographic twinkling artifact for the diagnosis of renal calculus in patients without known urolithiasis. AJR Am J Roentgenol. 206(2):326-31, 2016
                                          7. Ripollés T et al: Sonographic diagnosis of symptomatic ureteral calculi: usefulness of the twinkling artifact. Abdom Imaging. 38(4):863-9, 2013
                                          8. Spettel S et al: Using Hounsfield unit measurement and urine parameters to predict uric acid stones. Urology. 82(1):22-6, 2013
                                          9. Cheng PM et al: What the radiologist needs to know about urolithiasis: part 2--CT findings, reporting, and treatment. AJR Am J Roentgenol. 198(6):W548-54, 2012
                                          10. Cheng PM et al: What the radiologist needs to know about urolithiasis: part 1--pathogenesis, types, assessment, and variant anatomy. AJR Am J Roentgenol. 198(6):W540-7, 2012
                                          11. Dillman JR et al: Sonographic twinkling artifact for renal calculus detection: correlation with CT. Radiology. 259(3):911-6, 2011
                                          12. Kambadakone AR et al: New and evolving concepts in the imaging and management of urolithiasis: urologists' perspective. Radiographics. 30(3):603-23, 2010
                                          13. Eisner BH et al: Nephrolithiasis: what surgeons need to know. AJR Am J Roentgenol. 196(6):1274-8, 2011
                                          14. Oh Y et al: Urolithiasis. In Kim S: Radiology Illustrated: Uroradiology. 2nd ed. Springer. 552-95, 2012 
                                          15. Palmer JS et al: Diagnosis of pediatric urolithiasis: role of ultrasound and computerized tomography. J Urol. 174(4 Pt 1):1413-6, 2005
                                          16. Kamaya A et al: Twinkling artifact on color Doppler sonography: dependence on machine parameters and underlying cause. AJR Am J Roentgenol. 180(1):215-22, 2003
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Ureterovesicular junction (UVJ); ureteropelvic junction (UPJ); IV pyelogram (IVP)
                                                      • Synonyms

                                                        • Urinary tract stone, urinary calculous disease, nephrolithiasis, ureterolithiasis, vesicolithiasis
                                                      • Definitions

                                                        • Macroscopic concretions of crystals in urinary system ± mixed with proteins

                                                      IMAGING

                                                      • General Features

                                                        • Ultrasonographic Findings

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Liu N et al: Sonographic twinkling artifact for diagnosis of acute ureteral calculus. World J Urol. 38(2):489-95, 2020
                                                                                  2. Miller N et al: Evaluation and medical management of urinary lithiasis. In Partin et al: Campbell-Walsh Urology. 12th ed. Elsevier. 2036-68, 2020
                                                                                  3. Nourian A et al: Dual-energy CT for urinary stone evaluation. Curr Urol Rep. 22(1):1, 2020
                                                                                  4. Pearle M et al: Urinary Lithiasis: etiology, epidemiology, and pathogenesis. In Partin A et al: Campbell-Walsh Urology. 12th ed. Elsevier. 2005-35, 2020
                                                                                  5. Rule AD et al: Management of kidney stones in 2020. JAMA. 323(19):1961-2, 2020
                                                                                  6. Masch WR et al: Clinical effectiveness of prospectively reported sonographic twinkling artifact for the diagnosis of renal calculus in patients without known urolithiasis. AJR Am J Roentgenol. 206(2):326-31, 2016
                                                                                  7. Ripollés T et al: Sonographic diagnosis of symptomatic ureteral calculi: usefulness of the twinkling artifact. Abdom Imaging. 38(4):863-9, 2013
                                                                                  8. Spettel S et al: Using Hounsfield unit measurement and urine parameters to predict uric acid stones. Urology. 82(1):22-6, 2013
                                                                                  9. Cheng PM et al: What the radiologist needs to know about urolithiasis: part 2--CT findings, reporting, and treatment. AJR Am J Roentgenol. 198(6):W548-54, 2012
                                                                                  10. Cheng PM et al: What the radiologist needs to know about urolithiasis: part 1--pathogenesis, types, assessment, and variant anatomy. AJR Am J Roentgenol. 198(6):W540-7, 2012
                                                                                  11. Dillman JR et al: Sonographic twinkling artifact for renal calculus detection: correlation with CT. Radiology. 259(3):911-6, 2011
                                                                                  12. Kambadakone AR et al: New and evolving concepts in the imaging and management of urolithiasis: urologists' perspective. Radiographics. 30(3):603-23, 2010
                                                                                  13. Eisner BH et al: Nephrolithiasis: what surgeons need to know. AJR Am J Roentgenol. 196(6):1274-8, 2011
                                                                                  14. Oh Y et al: Urolithiasis. In Kim S: Radiology Illustrated: Uroradiology. 2nd ed. Springer. 552-95, 2012 
                                                                                  15. Palmer JS et al: Diagnosis of pediatric urolithiasis: role of ultrasound and computerized tomography. J Urol. 174(4 Pt 1):1413-6, 2005
                                                                                  16. Kamaya A et al: Twinkling artifact on color Doppler sonography: dependence on machine parameters and underlying cause. AJR Am J Roentgenol. 180(1):215-22, 2003