Caution – kidney stone diagnosis may miss more deadly conditions
Two weeks ago, I started on the issue of kidney stones and their diagnosis. Since then, I have been down with the “fluâ and a subsequent cough, which made it impossible to write. To summarize, I said that kidney stones, which cause pain, are not diagnosed solely by an ultrasound or x-ray, but mainly by a doctor taking the time to elicit the appropriate history and do a clinical examination.{{more}}
An ultrasound result is dependent on the doctor making the request and the one doing the test. I also said that a machine cannot replace a doctor, because ultrasounds and x-rays do not examine patients, they only help in making the diagnosis, but many a time can be misleading and even deadly! I know this sounds alarming, but let me explain.
The patient has pain; the doctor not taking the time to examine the patient and elicit a good history, diagnoses a kidney stone. He sends the patient for an ultrasound or X-ray of the abdomen and informs the radiologist that he is suspicious of a stone in the kidney. The radiologist sees a stone and the doctor assumes that this stone is causing the pain, but it might not be. In my experience, it usually isn’t. It is usually something else. These other things are called differential diagnoses. It can be a muscular strain, a leaking aortic aneurysm or balloon, a chest infection, a gall bladder obstruction or infection, bowel infection, obstruction or cancer, a stomach ulcer or cancer or shingles to name a few.
I am passionate about this diagnosis of a kidney stone, because every day I see patients with chronic pain diagnosed as kidney stones for months to years, only to find another diagnosis causing their pain. I have also seen patients whose appendix was removed, only for the pain to recur and a diagnosis of kidney or ureteral stone made.
I have seen a patient diagnosed with kidney stones that turned out to be a cancer in the left side of his colon. This is rare, but itâs more common to diagnose stomach problems and muscular strains.
Next week, I will look at the treatment of kidney stones.
For comments or question contact:
Dr Rohan Deshong
Tel: (784) 456-2785
email: deshong@vincysurf.com
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