Attack of urinary tract stone

Plain urinary tract x–ray

Analysis of urinary stone and urine sample

Serum and urine calcium, serum and urine urate, sodium, potassium and creatinine

Serum urate normal
Urine urate increased

Hereditary

End

Control examination
Renography after follow–up (stone 5 mm)

Spiral CT scan

Serum urate increased

Gout

Serum calcium increased

Cancer or immobilization?
Primary hyperpara–thyroidism – measure PTH

Serum calcium normal
Urine calcium increased

Idiopathic hypercalciuria?

Negative

Other causes of pain?

If no other causes are found, then

Positive