Kidney stone differential diagnosis: Difference between revisions

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==Overview==
==Overview==
Nephrolithiasis should be differentiated from other conditions presenting with acute flank or upper abdominal pain, hematuria, nausea and vomiting.
Nephrolithiasis should be differentiated from other conditions presenting with [[Flank Pain|acute flank]] or [[upper abdominal pain]], [[hematuria]], [[nausea and vomiting]].


==Differentiating Nephrolithiasis from other Diseases==
==Differentiating Nephrolithiasis from other Diseases==
Nephrolithiasis should be differentiated from other conditions presenting with acute flank or upper abdominal pain, hematuria, nausea and vomiting. The differentials include the following:<ref name="pmid18486720">{{cite journal |vauthors=Worcester EM, Coe FL |title=Nephrolithiasis |journal=Prim. Care |volume=35 |issue=2 |pages=369–91, vii |date=June 2008 |pmid=18486720 |pmc=2518455 |doi=10.1016/j.pop.2008.01.005 |url=}}</ref><ref name="pmid21789078">{{cite journal |vauthors=Semins MJ, Matlaga BR |title=Medical evaluation and management of urolithiasis |journal=Ther Adv Urol |volume=2 |issue=1 |pages=3–9 |date=February 2010 |pmid=21789078 |pmc=3126068 |doi=10.1177/1756287210369121 |url=}}</ref><ref name="pmid28764263">{{cite journal |vauthors=Venkatesh L, Hanumegowda RK |title=Acute Pyelonephritis - Correlation of Clinical Parameter with Radiological Imaging Abnormalities |journal=J Clin Diagn Res |volume=11 |issue=6 |pages=TC15–TC18 |date=June 2017 |pmid=28764263 |pmc=5535453 |doi=10.7860/JCDR/2017/27247.10033 |url=}}</ref><ref name="pmid17375337">{{cite journal |vauthors=Garin EH, Olavarria F, Araya C, Broussain M, Barrera C, Young L |title=Diagnostic significance of clinical and laboratory findings to localize site of urinary infection |journal=Pediatr. Nephrol. |volume=22 |issue=7 |pages=1002–6 |date=July 2007 |pmid=17375337 |doi=10.1007/s00467-007-0465-7 |url=}}</ref><ref name="pmid19399273">{{cite journal |vauthors=Lee DG, Jeon SH, Lee CH, Lee SJ, Kim JI, Chang SG |title=Acute pyelonephritis: clinical characteristics and the role of the surgical treatment |journal=J. Korean Med. Sci. |volume=24 |issue=2 |pages=296–301 |date=April 2009 |pmid=19399273 |pmc=2672131 |doi=10.3346/jkms.2009.24.2.296 |url=}}</ref><ref name="pmid22969301">{{cite journal |vauthors=Saeed K |title=Renal infarction |journal=Int J Nephrol Renovasc Dis |volume=5 |issue= |pages=119–23 |date=2012 |pmid=22969301 |pmc=3437809 |doi=10.2147/IJNRD.S33768 |url=}}</ref><ref name="pmid24812524">{{cite journal |vauthors=Mahamid M, Francis A, Abid A, Awawde M, Abu-Elhija O |title=Embolic renal infarction mimicking renal colic |journal=Int J Nephrol Renovasc Dis |volume=7 |issue= |pages=157–9 |date=2014 |pmid=24812524 |pmc=4011809 |doi=10.2147/IJNRD.S59745 |url=}}</ref><ref name="pmid12389340">{{cite journal |vauthors=Korzets Z, Plotkin E, Bernheim J, Zissin R |title=The clinical spectrum of acute renal infarction |journal=Isr. Med. Assoc. J. |volume=4 |issue=10 |pages=781–4 |date=October 2002 |pmid=12389340 |doi= |url=}}</ref><ref name="pmid12512867">{{cite journal |vauthors=Brix AE |title=Renal papillary necrosis |journal=Toxicol Pathol |volume=30 |issue=6 |pages=672–4 |date=2002 |pmid=12512867 |doi=10.1080/01926230290166760 |url=}}</ref><ref name="pmid7038374">{{cite journal |vauthors=Eknoyan G, Qunibi WY, Grissom RT, Tuma SN, Ayus JC |title=Renal papillary necrosis: an update |journal=Medicine (Baltimore) |volume=61 |issue=2 |pages=55–73 |date=March 1982 |pmid=7038374 |doi= |url=}}</ref><ref name="pmid18806169">{{cite journal |vauthors=Ng CS, Wood CG, Silverman PM, Tannir NM, Tamboli P, Sandler CM |title=Renal cell carcinoma: diagnosis, staging, and surveillance |journal=AJR Am J Roentgenol |volume=191 |issue=4 |pages=1220–32 |date=October 2008 |pmid=18806169 |doi=10.2214/AJR.07.3568 |url=}}</ref><ref name="pmid15536955">{{cite journal |vauthors=Ares Valdés Y, Amador Sandoval B, Morales JC, Alonso Domínguez F, Carballo Velásquez L, Fragas Valdés R, Shou Rodríguez A |title=[The role of CT scan in the diagnosis of renal cell carcinoma] |language=Spanish; Castilian |journal=Arch. Esp. Urol. |volume=57 |issue=7 |pages=737–42 |date=September 2004 |pmid=15536955 |doi= |url=}}</ref><ref name="pmid20479778">{{cite journal |vauthors=Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N |title=Imaging renal cell carcinoma with ultrasonography, CT and MRI |journal=Nat Rev Urol |volume=7 |issue=6 |pages=311–25 |date=June 2010 |pmid=20479778 |doi=10.1038/nrurol.2010.63 |url=}}</ref><ref name="pmid23596502">{{cite journal |vauthors=Tritschler S, Roosen A, Füllhase C, Stief CG, Rübben H |title=Urethral stricture: etiology, investigation and treatments |journal=Dtsch Arztebl Int |volume=110 |issue=13 |pages=220–6 |date=March 2013 |pmid=23596502 |pmc=3627163 |doi=10.3238/arztebl.2013.0220 |url=}}</ref><ref name="pmid21176068">{{cite journal |vauthors=Mundy AR, Andrich DE |title=Urethral strictures |journal=BJU Int. |volume=107 |issue=1 |pages=6–26 |date=January 2011 |pmid=21176068 |doi=10.1111/j.1464-410X.2010.09800.x |url=}}</ref><ref name="pmid26816803">{{cite journal |vauthors=Maciejewski C, Rourke K |title=Imaging of urethral stricture disease |journal=Transl Androl Urol |volume=4 |issue=1 |pages=2–9 |date=February 2015 |pmid=26816803 |pmc=4708283 |doi=10.3978/j.issn.2223-4683.2015.02.03 |url=}}</ref><ref name="pmid20664404">{{cite journal |vauthors=Soper DE |title=Pelvic inflammatory disease |journal=Obstet Gynecol |volume=116 |issue=2 Pt 1 |pages=419–28 |date=August 2010 |pmid=20664404 |doi=10.1097/AOG.0b013e3181e92c54 |url=}}</ref><ref name="pmid9891675">{{cite journal |vauthors=Paavonen J |title=Pelvic inflammatory disease. From diagnosis to prevention |journal=Dermatol Clin |volume=16 |issue=4 |pages=747–56, xii |date=October 1998 |pmid=9891675 |doi= |url=}}</ref><ref name="pmid24802548">{{cite journal |vauthors=Lee MH, Moon MH, Sung CK, Woo H, Oh S |title=CT findings of acute pelvic inflammatory disease |journal=Abdom Imaging |volume=39 |issue=6 |pages=1350–5 |date=December 2014 |pmid=24802548 |doi=10.1007/s00261-014-0158-1 |url=}}</ref><ref name="pmid17054801">{{cite journal |vauthors=Eggert J, Sundquist K, van Vuuren C, Fianu-Jonasson A |title=The clinical diagnosis of pelvic inflammatory disease--reuse of electronic medical record data from 189 patients visiting a Swedish university hospital emergency department |journal=BMC Womens Health |volume=6 |issue= |pages=16 |date=October 2006 |pmid=17054801 |pmc=1624808 |doi=10.1186/1472-6874-6-16 |url=}}</ref><ref name="pmid24294125">{{cite journal |vauthors=Washington C, Carmichael JC |title=Management of ischemic colitis |journal=Clin Colon Rectal Surg |volume=25 |issue=4 |pages=228–35 |date=December 2012 |pmid=24294125 |pmc=3577613 |doi=10.1055/s-0032-1329534 |url=}}</ref><ref name="pmid25941431">{{cite journal |vauthors=Chawla YK, Bodh V |title=Portal vein thrombosis |journal=J Clin Exp Hepatol |volume=5 |issue=1 |pages=22–40 |date=March 2015 |pmid=25941431 |pmc=4415192 |doi=10.1016/j.jceh.2014.12.008 |url=}}</ref><ref name="urlImaging of Abdominal Aortic Aneurysms - - American Family Physician">{{cite web |url=https://www.aafp.org/afp/2002/0415/p1565.html |title=Imaging of Abdominal Aortic Aneurysms - - American Family Physician |format= |work= |accessdate=}}</ref><ref name="pmid21523201">{{cite journal |vauthors=Aggarwal S, Qamar A, Sharma V, Sharma A |title=Abdominal aortic aneurysm: A comprehensive review |journal=Exp Clin Cardiol |volume=16 |issue=1 |pages=11–5 |date=2011 |pmid=21523201 |pmc=3076160 |doi= |url=}}</ref><ref name="pmid20676257">{{cite journal |vauthors=Destigter KK, Keating DP |title=Imaging update: acute colonic diverticulitis |journal=Clin Colon Rectal Surg |volume=22 |issue=3 |pages=147–55 |date=August 2009 |pmid=20676257 |pmc=2780264 |doi=10.1055/s-0029-1236158 |url=}}</ref><ref name="pmid24888393">{{cite journal |vauthors=Hameed AM, Lam VW, Pleass HC |title=Significant elevations of serum lipase not caused by pancreatitis: a systematic review |journal=HPB (Oxford) |volume=17 |issue=2 |pages=99–112 |date=February 2015 |pmid=24888393 |pmc=4299384 |doi=10.1111/hpb.12277 |url=}}</ref><ref name="urlImaging for Suspected Appendicitis - - American Family Physician">{{cite web |url=https://www.aafp.org/afp/2005/0101/p71.html |title=Imaging for Suspected Appendicitis - - American Family Physician |format= |work= |accessdate=}}</ref><ref name="urlCT Findings of Acute Cholecystitis and Its Complications : American Journal of Roentgenology : Vol. 194, No. 6 (AJR)">{{cite web |url=https://www.ajronline.org/doi/full/10.2214/AJR.09.3640 |title=CT Findings of Acute Cholecystitis and Its Complications : American Journal of Roentgenology : Vol. 194, No. 6 (AJR) |format= |work= |accessdate=}}</ref><ref name="urlEpididymitis and Orchitis: An Overview - - American Family Physician">{{cite web |url=https://www.aafp.org/afp/2009/0401/p583.html |title=Epididymitis and Orchitis: An Overview - - American Family Physician |format= |work= |accessdate=}}</ref><ref name="pmid26526901">{{cite journal |vauthors=Jia JB, Houshyar R, Verma S, Uchio E, Lall C |title=Prostate cancer on computed tomography: A direct comparison with multi-parametric magnetic resonance imaging and tissue pathology |journal=Eur J Radiol |volume=85 |issue=1 |pages=261–267 |date=January 2016 |pmid=26526901 |doi=10.1016/j.ejrad.2015.10.013 |url=}}</ref><ref name="pmid25393274">{{cite journal |vauthors=Bratt O, Lilja H |title=Serum markers in prostate cancer detection |journal=Curr Opin Urol |volume=25 |issue=1 |pages=59–64 |date=January 2015 |pmid=25393274 |pmc=4315142 |doi=10.1097/MOU.0000000000000128 |url=}}</ref><ref name="urlProstate Cancer (Prostate Carcinoma): Symptoms - National Library of Medicine - PubMed Health">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024422/ |title=Prostate Cancer (Prostate Carcinoma): Symptoms - National Library of Medicine - PubMed Health |format= |work= |accessdate=}}</ref><ref name="pmid25675798">{{cite journal |vauthors=Eskicioğlu F, Özdemir AT, Turan GA, Gür EB, Kasap E, Genç M |title=The efficacy of complete blood count parameters in the diagnosis of tubal ectopic pregnancy |journal=Ginekol. Pol. |volume=85 |issue=11 |pages=823–7 |date=November 2014 |pmid=25675798 |doi= |url=}}</ref><ref name="pmid21727242">{{cite journal |vauthors=Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW |title=Diagnosis and management of ectopic pregnancy |journal=J Fam Plann Reprod Health Care |volume=37 |issue=4 |pages=231–40 |date=October 2011 |pmid=21727242 |pmc=3213855 |doi=10.1136/jfprhc-2011-0073 |url=}}</ref>
Nephrolithiasis should be differentiated from other conditions presenting with [[Flank pain|acute flank]] or [[upper abdominal pain]], [[hematuria]], [[nausea and vomiting]]. The differentials include the following:<ref name="pmid18486720">{{cite journal |vauthors=Worcester EM, Coe FL |title=Nephrolithiasis |journal=Prim. Care |volume=35 |issue=2 |pages=369–91, vii |date=June 2008 |pmid=18486720 |pmc=2518455 |doi=10.1016/j.pop.2008.01.005 |url=}}</ref><ref name="pmid21789078">{{cite journal |vauthors=Semins MJ, Matlaga BR |title=Medical evaluation and management of urolithiasis |journal=Ther Adv Urol |volume=2 |issue=1 |pages=3–9 |date=February 2010 |pmid=21789078 |pmc=3126068 |doi=10.1177/1756287210369121 |url=}}</ref><ref name="pmid28764263">{{cite journal |vauthors=Venkatesh L, Hanumegowda RK |title=Acute Pyelonephritis - Correlation of Clinical Parameter with Radiological Imaging Abnormalities |journal=J Clin Diagn Res |volume=11 |issue=6 |pages=TC15–TC18 |date=June 2017 |pmid=28764263 |pmc=5535453 |doi=10.7860/JCDR/2017/27247.10033 |url=}}</ref><ref name="pmid17375337">{{cite journal |vauthors=Garin EH, Olavarria F, Araya C, Broussain M, Barrera C, Young L |title=Diagnostic significance of clinical and laboratory findings to localize site of urinary infection |journal=Pediatr. Nephrol. |volume=22 |issue=7 |pages=1002–6 |date=July 2007 |pmid=17375337 |doi=10.1007/s00467-007-0465-7 |url=}}</ref><ref name="pmid19399273">{{cite journal |vauthors=Lee DG, Jeon SH, Lee CH, Lee SJ, Kim JI, Chang SG |title=Acute pyelonephritis: clinical characteristics and the role of the surgical treatment |journal=J. Korean Med. Sci. |volume=24 |issue=2 |pages=296–301 |date=April 2009 |pmid=19399273 |pmc=2672131 |doi=10.3346/jkms.2009.24.2.296 |url=}}</ref><ref name="pmid22969301">{{cite journal |vauthors=Saeed K |title=Renal infarction |journal=Int J Nephrol Renovasc Dis |volume=5 |issue= |pages=119–23 |date=2012 |pmid=22969301 |pmc=3437809 |doi=10.2147/IJNRD.S33768 |url=}}</ref><ref name="pmid24812524">{{cite journal |vauthors=Mahamid M, Francis A, Abid A, Awawde M, Abu-Elhija O |title=Embolic renal infarction mimicking renal colic |journal=Int J Nephrol Renovasc Dis |volume=7 |issue= |pages=157–9 |date=2014 |pmid=24812524 |pmc=4011809 |doi=10.2147/IJNRD.S59745 |url=}}</ref><ref name="pmid12389340">{{cite journal |vauthors=Korzets Z, Plotkin E, Bernheim J, Zissin R |title=The clinical spectrum of acute renal infarction |journal=Isr. Med. Assoc. J. |volume=4 |issue=10 |pages=781–4 |date=October 2002 |pmid=12389340 |doi= |url=}}</ref><ref name="pmid12512867">{{cite journal |vauthors=Brix AE |title=Renal papillary necrosis |journal=Toxicol Pathol |volume=30 |issue=6 |pages=672–4 |date=2002 |pmid=12512867 |doi=10.1080/01926230290166760 |url=}}</ref><ref name="pmid7038374">{{cite journal |vauthors=Eknoyan G, Qunibi WY, Grissom RT, Tuma SN, Ayus JC |title=Renal papillary necrosis: an update |journal=Medicine (Baltimore) |volume=61 |issue=2 |pages=55–73 |date=March 1982 |pmid=7038374 |doi= |url=}}</ref><ref name="pmid18806169">{{cite journal |vauthors=Ng CS, Wood CG, Silverman PM, Tannir NM, Tamboli P, Sandler CM |title=Renal cell carcinoma: diagnosis, staging, and surveillance |journal=AJR Am J Roentgenol |volume=191 |issue=4 |pages=1220–32 |date=October 2008 |pmid=18806169 |doi=10.2214/AJR.07.3568 |url=}}</ref><ref name="pmid15536955">{{cite journal |vauthors=Ares Valdés Y, Amador Sandoval B, Morales JC, Alonso Domínguez F, Carballo Velásquez L, Fragas Valdés R, Shou Rodríguez A |title=[The role of CT scan in the diagnosis of renal cell carcinoma] |language=Spanish; Castilian |journal=Arch. Esp. Urol. |volume=57 |issue=7 |pages=737–42 |date=September 2004 |pmid=15536955 |doi= |url=}}</ref><ref name="pmid20479778">{{cite journal |vauthors=Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N |title=Imaging renal cell carcinoma with ultrasonography, CT and MRI |journal=Nat Rev Urol |volume=7 |issue=6 |pages=311–25 |date=June 2010 |pmid=20479778 |doi=10.1038/nrurol.2010.63 |url=}}</ref><ref name="pmid23596502">{{cite journal |vauthors=Tritschler S, Roosen A, Füllhase C, Stief CG, Rübben H |title=Urethral stricture: etiology, investigation and treatments |journal=Dtsch Arztebl Int |volume=110 |issue=13 |pages=220–6 |date=March 2013 |pmid=23596502 |pmc=3627163 |doi=10.3238/arztebl.2013.0220 |url=}}</ref><ref name="pmid21176068">{{cite journal |vauthors=Mundy AR, Andrich DE |title=Urethral strictures |journal=BJU Int. |volume=107 |issue=1 |pages=6–26 |date=January 2011 |pmid=21176068 |doi=10.1111/j.1464-410X.2010.09800.x |url=}}</ref><ref name="pmid26816803">{{cite journal |vauthors=Maciejewski C, Rourke K |title=Imaging of urethral stricture disease |journal=Transl Androl Urol |volume=4 |issue=1 |pages=2–9 |date=February 2015 |pmid=26816803 |pmc=4708283 |doi=10.3978/j.issn.2223-4683.2015.02.03 |url=}}</ref><ref name="pmid20664404">{{cite journal |vauthors=Soper DE |title=Pelvic inflammatory disease |journal=Obstet Gynecol |volume=116 |issue=2 Pt 1 |pages=419–28 |date=August 2010 |pmid=20664404 |doi=10.1097/AOG.0b013e3181e92c54 |url=}}</ref><ref name="pmid9891675">{{cite journal |vauthors=Paavonen J |title=Pelvic inflammatory disease. From diagnosis to prevention |journal=Dermatol Clin |volume=16 |issue=4 |pages=747–56, xii |date=October 1998 |pmid=9891675 |doi= |url=}}</ref><ref name="pmid24802548">{{cite journal |vauthors=Lee MH, Moon MH, Sung CK, Woo H, Oh S |title=CT findings of acute pelvic inflammatory disease |journal=Abdom Imaging |volume=39 |issue=6 |pages=1350–5 |date=December 2014 |pmid=24802548 |doi=10.1007/s00261-014-0158-1 |url=}}</ref><ref name="pmid17054801">{{cite journal |vauthors=Eggert J, Sundquist K, van Vuuren C, Fianu-Jonasson A |title=The clinical diagnosis of pelvic inflammatory disease--reuse of electronic medical record data from 189 patients visiting a Swedish university hospital emergency department |journal=BMC Womens Health |volume=6 |issue= |pages=16 |date=October 2006 |pmid=17054801 |pmc=1624808 |doi=10.1186/1472-6874-6-16 |url=}}</ref><ref name="pmid24294125">{{cite journal |vauthors=Washington C, Carmichael JC |title=Management of ischemic colitis |journal=Clin Colon Rectal Surg |volume=25 |issue=4 |pages=228–35 |date=December 2012 |pmid=24294125 |pmc=3577613 |doi=10.1055/s-0032-1329534 |url=}}</ref><ref name="pmid25941431">{{cite journal |vauthors=Chawla YK, Bodh V |title=Portal vein thrombosis |journal=J Clin Exp Hepatol |volume=5 |issue=1 |pages=22–40 |date=March 2015 |pmid=25941431 |pmc=4415192 |doi=10.1016/j.jceh.2014.12.008 |url=}}</ref><ref name="urlImaging of Abdominal Aortic Aneurysms - - American Family Physician">{{cite web |url=https://www.aafp.org/afp/2002/0415/p1565.html |title=Imaging of Abdominal Aortic Aneurysms - - American Family Physician |format= |work= |accessdate=}}</ref><ref name="pmid21523201">{{cite journal |vauthors=Aggarwal S, Qamar A, Sharma V, Sharma A |title=Abdominal aortic aneurysm: A comprehensive review |journal=Exp Clin Cardiol |volume=16 |issue=1 |pages=11–5 |date=2011 |pmid=21523201 |pmc=3076160 |doi= |url=}}</ref><ref name="pmid20676257">{{cite journal |vauthors=Destigter KK, Keating DP |title=Imaging update: acute colonic diverticulitis |journal=Clin Colon Rectal Surg |volume=22 |issue=3 |pages=147–55 |date=August 2009 |pmid=20676257 |pmc=2780264 |doi=10.1055/s-0029-1236158 |url=}}</ref><ref name="pmid24888393">{{cite journal |vauthors=Hameed AM, Lam VW, Pleass HC |title=Significant elevations of serum lipase not caused by pancreatitis: a systematic review |journal=HPB (Oxford) |volume=17 |issue=2 |pages=99–112 |date=February 2015 |pmid=24888393 |pmc=4299384 |doi=10.1111/hpb.12277 |url=}}</ref><ref name="urlImaging for Suspected Appendicitis - - American Family Physician">{{cite web |url=https://www.aafp.org/afp/2005/0101/p71.html |title=Imaging for Suspected Appendicitis - - American Family Physician |format= |work= |accessdate=}}</ref><ref name="urlCT Findings of Acute Cholecystitis and Its Complications : American Journal of Roentgenology : Vol. 194, No. 6 (AJR)">{{cite web |url=https://www.ajronline.org/doi/full/10.2214/AJR.09.3640 |title=CT Findings of Acute Cholecystitis and Its Complications : American Journal of Roentgenology : Vol. 194, No. 6 (AJR) |format= |work= |accessdate=}}</ref><ref name="urlEpididymitis and Orchitis: An Overview - - American Family Physician">{{cite web |url=https://www.aafp.org/afp/2009/0401/p583.html |title=Epididymitis and Orchitis: An Overview - - American Family Physician |format= |work= |accessdate=}}</ref><ref name="pmid26526901">{{cite journal |vauthors=Jia JB, Houshyar R, Verma S, Uchio E, Lall C |title=Prostate cancer on computed tomography: A direct comparison with multi-parametric magnetic resonance imaging and tissue pathology |journal=Eur J Radiol |volume=85 |issue=1 |pages=261–267 |date=January 2016 |pmid=26526901 |doi=10.1016/j.ejrad.2015.10.013 |url=}}</ref><ref name="pmid25393274">{{cite journal |vauthors=Bratt O, Lilja H |title=Serum markers in prostate cancer detection |journal=Curr Opin Urol |volume=25 |issue=1 |pages=59–64 |date=January 2015 |pmid=25393274 |pmc=4315142 |doi=10.1097/MOU.0000000000000128 |url=}}</ref><ref name="urlProstate Cancer (Prostate Carcinoma): Symptoms - National Library of Medicine - PubMed Health">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024422/ |title=Prostate Cancer (Prostate Carcinoma): Symptoms - National Library of Medicine - PubMed Health |format= |work= |accessdate=}}</ref><ref name="pmid25675798">{{cite journal |vauthors=Eskicioğlu F, Özdemir AT, Turan GA, Gür EB, Kasap E, Genç M |title=The efficacy of complete blood count parameters in the diagnosis of tubal ectopic pregnancy |journal=Ginekol. Pol. |volume=85 |issue=11 |pages=823–7 |date=November 2014 |pmid=25675798 |doi= |url=}}</ref><ref name="pmid21727242">{{cite journal |vauthors=Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW |title=Diagnosis and management of ectopic pregnancy |journal=J Fam Plann Reprod Health Care |volume=37 |issue=4 |pages=231–40 |date=October 2011 |pmid=21727242 |pmc=3213855 |doi=10.1136/jfprhc-2011-0073 |url=}}</ref>


{| class="wikitable"
{| class="wikitable"
Line 80: Line 80:
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|-
|-
|'''Pyelonephritis'''
|'''[[Pyelonephritis]]'''
|
|
* Urinary tract infection
* [[Urinary tract infection]]
* Immunocompromised state (Diabetes, immunosuppressive medications)
* [[Immunocompromised|Immunocompromised state]] ([[Diabetes]], [[Immunosuppresive drug|immunosuppressive]] medications)
* Urinary tract obstruction
* [[Urinary tract obstruction]]
* History of pyelonephritis
* History of [[pyelonephritis]]
* Pregnancy
* [[Pregnancy]]
* Presence of urinary catheter, stent, nephrostomy tube
* Presence of [[urinary catheter]], [[stent]], [[nephrostomy]] tube
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+ (microscopic)</nowiki>
|<nowiki>+ (microscopic)</nowiki>
Line 124: Line 124:
|'''[[Renal infarct]]'''
|'''[[Renal infarct]]'''
|
|
* Sickle cell disease or trait
* [[Sickle-cell disease|Sickle cell disease]] or trait
* Thrombosis
* [[Thrombosis]]
* Trauma
* [[Trauma]]
* Hypertension
* [[Hypertension]]
* Cardiac arrhythmia
* [[Cardiac arrhythmia]]
* Coagulopathy
* [[Coagulopathy]]
* Atherosclerosis
* [[Atherosclerosis]]
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
Line 162: Line 162:
|'''[[Renal papillary necrosis]]'''
|'''[[Renal papillary necrosis]]'''
|
|
* Analgesic use (Phenacetin, acetaminophen, NSAIDs)
* [[Analgesic]] use ([[Phenacetin]], [[acetaminophen]], [[NSAIDs]])
* Pyelonephritis
* [[Pyelonephritis]]
* Urinary tract obstruction
* [[Urinary tract obstruction]]
* Sickle cell disease
* [[Sickle cell disease]]
* Tuberculosis
* [[Tuberculosis]]
* Cirrhosis
* [[Cirrhosis]]
* Diabetes
* [[Diabetes]]
* Vasculitis
* [[Vasculitis]]
* Renal vein thrombosis
* [[Renal vein thrombosis]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+ (microscopic)</nowiki>
|<nowiki>+ (microscopic)</nowiki>
Line 206: Line 206:
|'''[[Renal cell carcinoma]]'''
|'''[[Renal cell carcinoma]]'''
|
|
* Weight loss
* [[Weight loss]]
* History of smoking
* History of [[smoking]]
* Obesity
* [[Obesity]]
* Von-Hippel Lindau disease
* [[Von Hippel-Lindau disease|Von-Hippel Lindau disease]]
* Night sweats
* [[Night sweats]]
* Malaise
* [[Malaise]]
* Flank mass
* Flank mass
| +
| +
Line 250: Line 250:
|'''Uretral stricture'''
|'''Uretral stricture'''
|
|
* Prior urinary tract surgery
* Prior [[urinary tract]] surgery
* Congenital
* [[Congenital]]
* Urinary catheterization
* [[Urinary catheterization]]
* Direct penile trauma
* Direct [[Penis|penile]] trauma
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
Line 283: Line 283:
|'''[[Pelvic inflammatory disease]]'''
|'''[[Pelvic inflammatory disease]]'''
|
|
* Endometritis
* [[Endometritis]]
* Saplingitis
* Saplingitis
* Cesarian section
* [[Caesarean section|Cesarian section]]
* Septic abortion
* Septic abortion
* Urinary tract infection
* [[Urinary tract infection]]
* Tuberculosis
* [[Tuberculosis]]
* Actinomycosis
* [[Actinomycosis]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
Line 329: Line 329:
|'''[[Ovarian torsion]]'''
|'''[[Ovarian torsion]]'''
|
|
* Sudden acute pain
* Sudden acute [[pain]]
* Sharp pain aggravated by walking
* Sharp [[pain]] aggravated by walking
* Intermittent/colicky pain
* Intermittent/colicky [[pain]]
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
Line 366: Line 366:
|'''[[Ectopic pregnancy]]'''
|'''[[Ectopic pregnancy]]'''
|
|
* History of previous ectopic pregnancy
* History of previous [[ectopic pregnancy]]
* Tubal surgery
* Tubal surgery
* Intrauterine device usage
* [[Intrauterine device]] usage
* History of pelvic surgery
* History of [[pelvic]] surgery
* History of pelvic inflammatory disease
* History of [[pelvic inflammatory disease]]
* Sub-fertility
* Sub-[[fertility]]
* Sternous excercise
* Sternous excercise
* Increased maternal age
* Increased [[maternal]] age
* Cigarette smoking
* [[Cigarette smoking]]
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
Line 410: Line 410:
|
|
* Bacterial infection by:
* Bacterial infection by:
** ''Ureaplasma urealyticum''
** ''[[Ureaplasma urealyticum]]''
** ''Proteus''
** ''[[Proteus]]''
** ''Chlamydia''
** ''[[Chlamydia]]''
** ''Gonorrhea''
** ''[[Gonorrhea]]''
** ''E.Coli''
** ''[[E.Coli]]''
** ''Pseudomonas''
** ''[[Pseudomonas]]''
** ''Mycoplasma''
** ''[[Mycoplasma]]''
* Prior history of prostatitis
* Prior history of [[prostatitis]]
* Urinary tract infection
* [[Urinary tract infection]]
* Urinary catheterization
* [[Urinary catheterization]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
Line 456: Line 456:
|'''[[Prostatic cancer]]'''
|'''[[Prostatic cancer]]'''
|
|
* Family history of prostate cancer (1st degree relatives)
* [[Family history]] of [[Prostate cancer|prostate cance]]<nowiki/>r (1st degree relatives)
* Germline mutation of HOXB13 (G84E variant)
* [[Germline mutation]] of [[HOXB13]] (G84E variant)
* Black ethnicity
* Black ethnicity
* Age > 50 years
* Age > 50 years
Line 496: Line 496:
|
|
* Age 12 - 16 years
* Age 12 - 16 years
* Previous history of testicular torsion
* Previous history of [[testicular torsion]]
* Family history of testicular torsion
* [[Family history]] of [[testicular torsion]]
* Prematurity
* [[Prematurity]]
* Undescended testes
* [[Undescended testes]]
* Low birth weight
* [[Low birth weight]]
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
Line 533: Line 533:
|
|
* Unprotected sexual intercourse
* Unprotected sexual intercourse
* Mumps, coxsackie virus infection
* [[Mumps]], [[Coxsackie virus|coxsackie]] virus infection
* Concurrent epididymitis
* Concurrent [[epididymitis]]
* Congenital abnornmalities
* [[Congenital disorder|Congenital abnornmalities]]
* Prostatitis
* [[Prostatitis]]
* Prostatic hypertrophy or calculi
* [[Prostatic hypertrophy]] or [[calculi]]
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
Line 573: Line 573:
|
|
* Female gender
* Female gender
* Obesity
* [[Obesity]]
* Pregnancy (increased progesterone promotes biliary stasis)
* [[Pregnancy]] (increased [[progesterone]] promotes biliary stasis)
* Rapid weight loss
* Rapid [[weight loss]]
* Oral contraceptive use
* [[Oral contraceptive|Oral contraceptive use]]
* Increasing age
* Increasing age
* Total parenteral nutrition
* [[Total parenteral nutrition]]
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
Line 618: Line 618:
|
|
* Male gender
* Male gender
* Adolescents
* [[Adolescent|Adolescents]]
* Diet low in fiber and high in refined carbohydrates
* Diet low in fiber and high in refined [[carbohydrates]]
* History of appendicitis in first degree relatives
* History of [[appendicitis]] in first degree relatives
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
Line 660: Line 660:
|'''[[Diverticulitis]]'''
|'''[[Diverticulitis]]'''
|
|
* Diverticulosis
* [[Diverticulosis]]
* Low fiber diet
* Low [[Fiber|fiber diet]]
* Old age
* Old age
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
Line 697: Line 697:
|'''[[Abdominal aortic aneurysm]]'''
|'''[[Abdominal aortic aneurysm]]'''
|
|
* Hypertension
* [[Hypertension]]
* Cigarette smoking
* [[Cigarette smoking]]
* Pulsatile abdominal mass
* [[Pulsatile Flow|Pulsatile]] [[abdominal mass]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
Line 734: Line 734:
|
|
* Mutated JAK2 V617F
* Mutated JAK2 V617F
* Anti-phospholipid syndrome
* [[Antiphospholipid syndrome|Anti-phospholipid syndrome]]
* Paroxysmal nocturnal hemoglobinuria
* [[Paroxysmal nocturnal hemoglobinuria]]
* Homocysteinuria
* [[Homocysteinuria]]
* Factor V Leiden
* [[Factor V Leiden]]
* Prothrombin mutation G20210A
* [[Prothrombin G20210A mutation|Prothrombin mutation G20210A]]
* Protein C or S deficiency
* [[Protein C deficiency|Protein C]] or [[Protein S deficiency|S deficiency]]
* Oral contraceptive use
* [[Oral contraceptive|Oral contraceptive use]]
* Cirrhosis
* [[Cirrhosis]]
* Pregnancy and post-partum
* [[Pregnancy]] and [[post-partum]]
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>

Revision as of 03:57, 21 May 2018

Kidney stone Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

Nephrolithiasis should be differentiated from other conditions presenting with acute flank or upper abdominal pain, hematuria, nausea and vomiting.

Differentiating Nephrolithiasis from other Diseases

Nephrolithiasis should be differentiated from other conditions presenting with acute flank or upper abdominal pain, hematuria, nausea and vomiting. The differentials include the following:[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]

Category Disease History Signs and Symptoms Physical Examination Laboratory abnormalities
Nausea/vomiting Hematuria Location of pain Fever Tachycardia Hypotension Hypertension Anorexia Constipation Rebound abdominal tenderness Urinary frequency/Urgency/Dysuria Costovetebral angle tenderness Pelvic Examination Rectal Examination Complete Blood Count (CBC) Urinalysis BUN Creatinine Stone analysis Urine Beta- hCG Abnormal Liver Function Tests (LFTs) Serum Amylase/Lipase Abdominal/Pelvic CT scan Serum Parathyroid hormone levels (PTH)

Renal Pathology

Nephrolithiasis + +
  • Flank/back pain radiating to groin
- + - - +/- - - + - - - - - - -
  • Non-contrast CT scan may show stone as radiolucency
+/-
Pyelonephritis + + (microscopic)
  • Costovertebral angle
  • Positive renal punch sign
+ + + - +/- - + + +
  • Uretheritis
  • Vaginitis
-
  • Leukocytosis
  • Pyuria
  • Positive leukocyte esterase
- - - -
  • Globaly decreased contrast uptake
  •  Foci from abscess pockets
-
Renal infarct + +
  • Flank pain
+ + - + - - - - - - -
  • Leukocytosis
  • Red blood cells
  • Proteinuria
- - -
Renal papillary necrosis - + (microscopic)
  • Flank pain
+ +/- - + - - - + - - -
  • Bacteriuria
  • Pyuria
  • Microscopic hematuria
- - - -
  • Blunted renal calyces
  • Contrast material–filled clefts in the renal medulla
  • Non-enhanced lesions surrounded by rings of excreted contrast material
  • Hyperattenuated medullary calcifications
-
Renal cell carcinoma + + (microscopic)
  • Flank pain
- - - + + +/- - - - - -
  • Anemia
  • Microscopic hemeturia
  • Renal cell casts
  • Urinary aquaporin-1 (AQP1) and adipophilin (ADFP)- proximal renal tubular cancer
- - - -
  • Non-contrast CT:
    • Lesions are soft tissue attenuation 
    • Areas of calcification and necrosis
  • Contrast-enhanced:
    • Homogenous (small lesions) to irregular (large lesions) contrast enhancement
-
Uretral stricture - +/- - - - - - - - - + - - - - - - - - - - -

Gynecological Pathology

Pelvic inflammatory disease - -
  • Right/left upper quadrant
+ + + - + - - + -
  • Cervical motion tenderness
  • Adnexal tenderness
  • Foul smelling vaginal/urtetheral discharge
-
  • Leukocytosis
  • Bacteriuria (Neisseria gonorrhoeae or Chlamydia trachomatis, polymicrobial)
  • Pyuria
- - - -
  • Thickening of the uterosacral ligaments
  • Haziness of the pelvic fat
  • Periovarian stranding
  • Enhancement of the adjacent peritoneum
  • Thick-walled, complex fluid collection with septa formation (abscess pockets)
-
Ovarian torsion
  • Sudden acute pain
  • Sharp pain aggravated by walking
  • Intermittent/colicky pain
+ -
  • Unilateral poorly localized lower abdominal
- + - - - - - - -
  • Adnexal tenderness
  • Adnexal mass
- - - - - - - - -
  • Twisted ovarian pedicle
  • Enlarged ovary (>4.0 cm)
  • Distended pedicle
  • Possible underlying ovarian lesion
-
Ectopic pregnancy + -
  • Lower abdominal
  • Unilateral shoulder or neck pain (referred)
- + - - + - + (if ruptured) + -
  • Vaginal bleeding
-
  • Low platelet distribution width (decreased platelet activation)
  • Monocytosis
- - - - + +/- - N/A -

Prostate Pathology

Prostatitis - +
  • Perineal pain
  • Lower back pain
  • Suprapubic pain
+ + - - - - - + - -
  • Enlarged prostate
  • Rectal pain
  • Leukocytosis
  • Bacteriuria
  • Pyuria
  • Microscopic hematuria
- - - - - - -
Prostatic cancer - + - - - - - + - - + - -
  • Enlarged prostate
  • Firm and hard
-
  • Positive prostate specific antigen (PSA)
  • High levels of TMPRSS2:ERG and PCA3
- - - -
  • Focal areas of mass-like enhancement in the peripheral prostate
  • Calcifications
-

Testicular Pathology

Testicular torsion + -
  • Sudden onset unilateral testicular pain
- + - - +/- - - +/- -
  • Absent cremasteric reflex
  • Testicle may be swollen, tender, and high-riding, with an abnormal transverse lie.
- - - - - - - - -
  • Doppler ultrasound > CT scan for diagnosis (abscence of blood flow in the affected testis)
-
Orchitis + -
  • Abrupt onset of testicular pain
+ + - - - - - +/- -
  • Testicular swelling and tenderness
  • Normal cremasteric reflex
-
  • Leukocytosis
- - - - - - -
  • Ultrasound > CT scan for diagnosis (Testicular masses or swollen testicles with hypoechoic and hypervascular areas)
-

Abdominal Pathology

Cholecystitis + -
  • Right upper abdominal quadrant pain
  • Flank pain
+ + - - + - - - - - -
  • Leukocytosis
- - -
  • Bilirubin (pigment) stones
  • Cholesterol stones
- + +/-
  • Gallbladder distention
  • Wall thickening
  • Mucosal hyperenhancement,
  • Pericholecystic fat stranding or fluid
  • Gallstones
-
Appendicitis + -
  • Pain in umblical area
  • Radiating to right lower abdominal quadrant
+ + - - + - + +/- - - -
  • Leukocytosis
- - - - - - + (if perforation)
  • Larger than 6 mm in diameter,
  • Appendiceal wall thickening
  • Wall enhancement after contrast media infusion
  • Inflammatory fat stranding
  • Phlegmon
  • Free fluid
  • Free air bubbles
  • Abscess
  • Adenopathy
-
Diverticulitis + -
  • Left lower abdominal quadrant
+ + - - + + - - - -
  • Bleeding
  • Rectal mass
  • Rectal tenderness
  • Leukocytosis
- - - - - - + (if perforation)
  • Colonic wall thickening (wall thickness is greater than 3 mm on the short axis of the lumen)
  • Pericolic fat stranding
-
Abdominal aortic aneurysm - -
  • Epigastric pain
  • Deep boring pain in the back
  • May radiate to flank
- + + - - - + (if rupture) - - - - - - - - - - - -
  • Ultrasound more sensitive than CT scan
  • CT scan may accurately predict the aneurysmal size
  • Helical CT has faster scanning time (30 to 60 seconds) and the ability to obtain all images in one breath hold
-
Portal vein thrombosis + -
  • Abdominal or lumbar pain
+ + + - + - + (if bowel ischemia or infarction-secondary to extension of thrombus to superior mesenteric artery) - - -
  • Hematochezia
  • Anemia
  • Thrombocytopenia
- - - - - + + (if bowel infarction, perforation)
  • On non-contrast CT:
    • Hyperdense thrombus
  • On contrast CT
    • Non-enhancing defect of bland thrombus
    • Tumor thrombus exhibits enhancement
Duodenal ulcer
  • Pain relieved by intake of food
  • Helicobacter pylori infection
  • Tobacco smoking
  • NSAID use
  • EtOH use
  • Older age
  • Female gender
  • Family history of duodenal ulcers
+ -
  • Epigastric pain
+ + + - - - + (if perforation) - - -
  • Melena
  • Anemia
- - - - + (if bowel perforation)
  • Endoscopy > CT scan for diagnosis
-
Ischemic colitis
  • Age > 60 years
  • Hemodialysis
  • Hypertension
  • Hypoalbuminemia
  • Diabetes mellitus
+ -
  • Acute-onset abdominal cramping 
+ + + (if necrosis and sepsis) + + + + (if transmural necrosis) - - -
  • Hematochezia
  • Leukocytois (if necrosis)
  • Anemia (if perforation and bleeding)
- - - - + (if bowel perforation)
  • Bowel wall thickening
  • Thumbprinting
  • Pericolonic stranding with or without ascites.
  • Double halo or target sign 
  • Submucosal edema or hemorrhage
  • Pneumatosis coli (if infarction)
-

References

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  14. Tritschler S, Roosen A, Füllhase C, Stief CG, Rübben H (March 2013). "Urethral stricture: etiology, investigation and treatments". Dtsch Arztebl Int. 110 (13): 220–6. doi:10.3238/arztebl.2013.0220. PMC 3627163. PMID 23596502.
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  17. Soper DE (August 2010). "Pelvic inflammatory disease". Obstet Gynecol. 116 (2 Pt 1): 419–28. doi:10.1097/AOG.0b013e3181e92c54. PMID 20664404.
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  25. Destigter KK, Keating DP (August 2009). "Imaging update: acute colonic diverticulitis". Clin Colon Rectal Surg. 22 (3): 147–55. doi:10.1055/s-0029-1236158. PMC 2780264. PMID 20676257.
  26. Hameed AM, Lam VW, Pleass HC (February 2015). "Significant elevations of serum lipase not caused by pancreatitis: a systematic review". HPB (Oxford). 17 (2): 99–112. doi:10.1111/hpb.12277. PMC 4299384. PMID 24888393.
  27. "Imaging for Suspected Appendicitis - - American Family Physician".
  28. "CT Findings of Acute Cholecystitis and Its Complications : American Journal of Roentgenology : Vol. 194, No. 6 (AJR)".
  29. "Epididymitis and Orchitis: An Overview - - American Family Physician".
  30. Jia JB, Houshyar R, Verma S, Uchio E, Lall C (January 2016). "Prostate cancer on computed tomography: A direct comparison with multi-parametric magnetic resonance imaging and tissue pathology". Eur J Radiol. 85 (1): 261–267. doi:10.1016/j.ejrad.2015.10.013. PMID 26526901.
  31. Bratt O, Lilja H (January 2015). "Serum markers in prostate cancer detection". Curr Opin Urol. 25 (1): 59–64. doi:10.1097/MOU.0000000000000128. PMC 4315142. PMID 25393274.
  32. "Prostate Cancer (Prostate Carcinoma): Symptoms - National Library of Medicine - PubMed Health".
  33. Eskicioğlu F, Özdemir AT, Turan GA, Gür EB, Kasap E, Genç M (November 2014). "The efficacy of complete blood count parameters in the diagnosis of tubal ectopic pregnancy". Ginekol. Pol. 85 (11): 823–7. PMID 25675798.
  34. Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW (October 2011). "Diagnosis and management of ectopic pregnancy". J Fam Plann Reprod Health Care. 37 (4): 231–40. doi:10.1136/jfprhc-2011-0073. PMC 3213855. PMID 21727242.

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