• CT analysis of renal stone composition: A novel and non invasive method to analyse stones

      Harrington, K; Torreggiani, W (Irish Medical Journal (IMJ), 2014-03)
      The treatment of renal stone disease is very dependent on the composition of the stone. Uric acid stones for example have a completely differerent eitiology and treatment pathway to calcium phosphate or oxalate stones. Until now, the diagnosis of renal stone disease was mainly done through urine analysis and formal stone analysis once the stone has been removed. There is now a novel method of analysing the composition of stones by utilisation of dual energy CT, a technology that we have recently introduced to Ireland. CT not only has the ability to detect stones with a sensitivity of close to 100%, but now has the ability to actually give a breakdown of the underlying composition of the stone. Renal stone disease is estimated to have a lifetime incidence of up to 15%, thus making it a common presentation to both the primary care setting and emergency departments1. The classical presentation of loin to groin colicky pain with haematuria is well known. More atypical symptoms include abdominal pain, nausea, urinary frequency or difficulty voiding. The majority of renal stones are calcium oxalate stones and account for up to 75-80% of renal stones. Struvite (magnesium ammonium phosphate), calcium phosphate, uric acid, cysteine and mixed stones make up the remaining 20-25%2.