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How kidney stones are diagnosed
Kidney stones are usually diagnosed by a GP or in hospital after discussing your symptoms and carrying out a physical examination. The doctor will ask about pain, blood in your urine, sickness, and any previous kidney stones. They may also ask how suddenly the symptoms started and whether the pain comes in waves.
Because kidney stones can cause similar symptoms to other conditions, diagnosis is often based on a combination of signs, tests, and imaging. The aim is to confirm whether a stone is present, where it is located, and whether it is blocking urine flow. This helps decide how urgent treatment needs to be.
What the doctor will ask
Your doctor will usually begin with questions about your symptoms and medical history. They may ask if you have had fever, chills, nausea, vomiting, or pain in your back, side, groin, or lower abdomen. They may also ask about dehydration, diet, and any family history of kidney stones.
If you have had stones before, this information is especially useful. Recurrent stones can suggest an underlying cause that may need further investigation. Your doctor may also ask what medicines you take, as some drugs can affect stone formation.
Urine and blood tests
A urine test is often one of the first checks. It can show blood in the urine, signs of infection, or crystals that may suggest a stone is forming. In some cases, the sample may also be sent to the laboratory for further testing.
Blood tests may be done to check kidney function, infection markers, and levels of substances such as calcium and uric acid. These results can help identify possible causes and show whether the kidneys are being affected. If you are unwell, blood tests can also help rule out more serious problems.
Imaging tests
Imaging is usually needed to confirm the diagnosis. A non-contrast CT scan is often the most accurate test and can show the size, shape, and exact position of a stone. It can also reveal whether the stone is causing a blockage.
Sometimes an ultrasound scan is used instead, especially for children, pregnant people, or when doctors want to avoid radiation. An X-ray may also be used in some cases, although it does not show all types of stones. The choice of test depends on your symptoms and medical history.
When to seek urgent help
Seek urgent medical advice if you have severe pain, fever, vomiting, or difficulty passing urine. These can be signs that the kidney stone is causing an infection or a serious blockage. In the UK, this may mean contacting NHS 111, your GP urgently, or attending A&E.
Prompt diagnosis is important because treatment can reduce pain and prevent complications. It also helps doctors decide whether you can pass the stone naturally or need a procedure to remove it. If you are unsure, it is always safer to get checked early.
Frequently Asked Questions
Kidney stones are usually diagnosed through a combination of medical history, physical exam, urine tests, blood tests, and imaging studies such as a CT scan, ultrasound, or X-ray.
Doctors may suspect a kidney stone when a person has severe flank pain, pain that moves toward the groin, blood in the urine, nausea, vomiting, or trouble urinating.
A non-contrast CT scan is often the most accurate test for diagnosing kidney stones because it can detect stones of many sizes and locations.
Yes. In some cases, ultrasound, plain X-rays, urine tests, blood tests, and symptoms can help diagnose a kidney stone without a CT scan.
A urine test can check for blood, signs of infection, crystals, and other abnormalities that may suggest a kidney stone or a related problem.
Blood tests may be used to check kidney function, measure electrolytes, and look for signs of infection or other causes of the symptoms.
Some kidney stones can be seen on a plain X-ray, but not all stones show up clearly, so X-rays are less sensitive than CT scans.
Ultrasound is often used when radiation should be avoided, such as during pregnancy, or as an initial test in some patients.
Most kidney stones can be detected with imaging, but very small stones or certain stone types may be harder to see on some tests.
Symptoms can strongly suggest a kidney stone, but imaging and lab tests are usually needed to confirm the diagnosis and rule out other causes.
Other conditions like appendicitis, gallstones, infections, or ovarian problems can cause similar pain, so doctors need to rule them out before confirming a kidney stone.
Blood in the urine is common with kidney stones and can support the diagnosis, but it does not prove a stone is present by itself.
Yes. If a stone is causing blockage and infection, doctors may notice fever, chills, and abnormal urine or blood tests, which can make the situation more urgent.
Imaging tests such as CT scans or ultrasound are used to estimate the size, number, and location of kidney stones.
The location helps doctors predict whether the stone will pass on its own and what treatment may be needed.
People with recurrent stones may still need imaging and lab tests, but doctors may also do a metabolic evaluation to look for causes of repeated stone formation.
A metabolic evaluation may include blood tests and a 24-hour urine collection to identify factors that increase stone risk, especially in people with repeated stones.
A 24-hour urine test is usually not used to find a stone already causing symptoms, but it can help identify why stones are forming.
Kidney stones can sometimes be diagnosed quickly in an emergency setting, especially if imaging is done soon after symptoms begin.
You can expect questions about your pain and symptoms, a physical exam, urine and blood tests, and often imaging to confirm whether a kidney stone is present.
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