The doctor will ask you questions regarding the timing, nature, progression, and any changes in the pains that you have felt. It is also very important to know all the other symptoms that you have experienced, including any fever and burning with urination.

In addition to checking for any history of kidney stones (yours or your family members’), the doctor will need to be updated on all of your medical problems and the names of the medications you are currently taking.

The doctor will do a physical examination that will include a thorough evaluation with a specific focus on your abdomen and back, with a testicular exam in males.

The doctor will order the laboratory to do a dipstick and microscopic analysis of a urine sample. This is one of the most important tests in the beginning and may be one of the hardest because you often will have a hard time giving a urine sample. The doctor may also have your blood tested to look for signs of infection and to check on kidney functioning.

The emergency department may use an ultrasound machine and a plain abdominal x-ray called a KUB (for kidneys, ureters, and bladder) as a quick screening to look for blockage. If you already know that you have a stone, these techniques may be used to help find the position of a migrating stone.

X-rays and ultrasound examinations may also be performed by technicians and read by a radiologist outside of the emergency department. Ultrasound is very important if you are pregnant and cannot be exposed to x-rays.

Intravenous pyelography (IVP) is a dye study that may also be performed to look at your kidney function and to check for a kidney stone. Dye is injected through an IV catheter, and many x-rays are taken over a period of time. A special non-ionic dye should be used if you have asthma, multiple allergies, severe cardiac disease, or have had a previous reaction to the less expensive ionic contrast agents. The IVP study shows how well your kidneys are functioning and may also be done later by a urologist if it wasn’t used for diagnosis.

A CT scan of your abdomen (which can be done with or without IV contrast dye) is being used more frequently as a test to check for kidney stones. This very rapid and sensitive test also reveals other diseases that might mimic a kidney stone, such as abdominal aortic aneurysms, diverticular disease of the bowel, pancreatitis, appendicitis, or disorders of the gallbladder.