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Date of last update: 8/13/2017.

Forum Name: Urology Topics

Question: Can ultrasound detect small stones?


 grd - Mon Jun 07, 2010 8:55 am

Hi,
I'm 28 years old male. About 6 weeks back, I had a mild fever and there was blood in the urine (it was visible- reddish brown in color). I went to a doctor and after doing a urine test, he gave me antibiotics for 10 days. The 'visible' blood in urine was there for only one day. 3 days later i felt a pain in my right flank. The pain remained for about 2 hours and vanished. But from that day onwards I felt a discomfort (kinda very mild pain) in my right flank when I do some physical work.

After 10 days i again felt a heavy pain in my right flank. This time too it remained for about 2 hours and vanished. But the discomfort in my right side continued. I tried to fix a appointment with a urologist and I got the appointment only after 1 week. I started drinking lot of water (6 to 7 litres of water daily) in the meantime and the discomfort in my right side gradually reduced and by the time I met the urologist I had no discomfort.

The urologist did a ultrasound test and told me that everything is fine. He also told me that the stone might have passed. But he asked me to do a CT scan for further examination which I could not do because the cost of the scan was unaffordable for me at that time and also because I felt that my problem was over.

last week (which is 2 weeks after I met the urologist) I again felt a mild pain in the right flank and the next day again there was that reddish brown urine. This time I also felt a constant urge to urinate and a mild burning sensation while urinating. I again started drinking lot of water and now its gone.

My questions are

-I read somewhere that ultrasound cannot detect small stones. is it true? if it is true, then is there a possibility that on the day the ultrasound was performed the stone may be small and now it might have got enlarged (in 15 days time) and creating problem ???

-is it something other than kidney stones to worry about?

Thanks
 Dr.M.Aroon kamath - Sun Jun 13, 2010 2:55 am

User avatar Hi,
There are some conditions that can cause pain similar to 'renal colic'(typically attributed to urinary stones).
- blood clots(clot colic)
- urinary sediment(crystalluria).

Although an ultrasound may miss very small stones, CT scans(helical CT) are capable of picking up stones of even 1mm size.

The history of your illness appears to suggest a fixed renal pain than a classical renal colic. As it had been constantly associated with hematuia and stone disease had not been demonstrated, one needs to entertain other differential diagnoses as well.

Your urologist may be the right person to plan the diagnostic appproach in your case.However, it is probable that you may need
- a microscopic examination of the urinary sediment,
- urinary culture/sensitivity testing &
- an Helical CT to look for urolithiasis/tumors of the urothelium.

Good luck!

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