What are the recommended initial investigations for a patient presenting with suspected kidney stones?

For patients presenting with suspected kidney stones (renal or ureteric colic), the recommended initial investigations primarily involve urgent imaging ¹,²,³.

• Urgent Imaging: Imaging should be arranged urgently, within 24 hours of presentation, to confirm the diagnosis and assess the likelihood of spontaneous stone passage ¹,²,³.
  • For most adults, low-dose non-contrast CT (computed tomography) is offered ¹,²,³.
  • If a woman is pregnant, ultrasound is offered instead of CT ¹,²,³.
  • For children and young people, ultrasound is offered first-line ¹,²,³. Low-dose non-contrast CT may be considered if there is still uncertainty about the diagnosis after an ultrasound scan ¹,²,³.
• Metabolic Investigations: Metabolic investigations are also recommended to determine the type of stone and any potential underlying causes ¹,². For adults with ureteric or renal stones, stone analysis and measurement of serum calcium should be considered ³.