Many people know that the most obvious symptom of kidney stones is pain in the lower back and abdomen, also known as renal colic. This pain is intermittent, and in the early stages, it can be quite intense. However, because of this, many people cannot distinguish between the pain caused by right kidney stones and the pain caused by other diseases, leading to misdiagnosis. Below, I will teach you how to differentiate between the pain caused by right kidney stones and other diseases.
1. Kidney stones and renal tuberculosis
Renal tuberculosis can also cause pain and symptoms such as hematuria. Calcium deposits in the renal area can be seen on flat abdominal films. However, renal tuberculosis often has some characteristic manifestations, such as bladder irritation symptoms. Venous urography can show kidney damage and the presence of pyuria. However, routine urine culture is negative while acid-fast staining is positive. CT scans are often helpful in differentiation.
2. Kidney stones and renal tumors
Tumors of the renal pelvis or calyces can appear as filling defects on venous urography, which can easily be confused with negative stones. Pain or obstruction can also occur when necrotic tissue or blood clots are expelled.
3. Kidney stones and acute appendicitis
Pain in the lower right abdomen caused by a right ureteral stone can be easily confused with appendicitis and needs to be differentiated. In the case of acute appendicitis, the abdominal pain is as severe and persistent as that caused by stones. There is tenderness, rebound tenderness, and muscle tension in the affected area. Fever and increased white blood cell count may also be present. Urine examination shows no red blood cells. Ultrasound and X-ray examinations show no stone shadows, which can help differentiate between the two.
4. Kidney stones and papillary necrosis
If papillary necrosis of the kidney falls off and remains in the renal pelvis, it can cause peripheral calcification. On X-rays, it appears similar to uric acid stones wrapped in a calcium shell. Differential diagnosis relies on medical history, pyuria, renal dysfunction, and the specific imaging features of detached papilla.
5. Kidney stones and cholelithiasis
Right kidney stones need to be differentiated from cholelithiasis. Gallstones primarily cause pain in the upper right abdomen that radiates to the right shoulder and back. B-ultrasound and cholecystography can detect the presence of stone shadows and assist in differentiation.
6. Kidney stones and acute pyelonephritis
Acute pyelonephritis can cause hematuria and needs to be differentiated from kidney and ureteral stones. However, the former has symptoms of systemic toxicity, such as fever. B-ultrasound and A-line examinations can assist in differentiation.
7. Kidney stones and acute pancreatitis
Acute pancreatitis often occurs suddenly after overeating and may have a history of biliary disease. It causes pain in the upper abdomen, mostly on the left side, which can radiate to the entire abdomen and the back. There is persistent severe pain, abdominal tenderness, and muscle tension. Increased blood amylase levels and total white blood cell count can be observed. It can be differentiated from kidney stones.
8. Kidney stones and acute perforation of duodenal ulcers
It occurs suddenly and is associated with a history of ulcer disease. It starts in the upper abdomen and quickly spreads to the entire abdomen. There is persistent cutting pain, rigid abdomen, abdominal tenderness, rebound tenderness, and loss of liver dullness. X-ray abdominal fluoroscopy can reveal free gas below the diaphragm.
Above are the differences between right kidney stones and other diseases in the lower back and abdomen. In general, when experiencing pain, it is necessary to go to the hospital for examination. The doctor will help you identify the type of disease and provide appropriate advice.
