Which physical findings are characteristic of nephrolithiasis?

Updated: Sep 16, 2021
  • Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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The diagnosis of nephrolithiasis is often made on the basis of clinical symptoms alone, although confirmatory tests are usually performed.

Examination in patients with nephrolithiasis includes the following findings:

  • Dramatic costovertebral angle tenderness; pain can move to upper/lower abdominal quadrant with migration of ureteral stone

  • Generally unremarkable abdominal evaluation: Possibly hypoactive bowel sounds; usually absence of peritoneal signs; possibly painful testicles but normal-appearing

  • Constant body positional movements (eg, writhing, pacing)

  • Tachycardia

  • Hypertension

  • Microscopic hematuria

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