What are the indications for imaging in patients with suspected kidney stones?

Indications for imaging in patients with suspected kidney stones include:

• Urgent imaging (within 24 hours of presentation) is recommended for all adults, children, and young people with suspected renal or ureteric stones to confirm diagnosis and assess the likelihood of spontaneous stone passage.
• Immediate hospital admission and imaging should be arranged if the patient has signs of systemic infection or sepsis (e.g., fever), is at increased risk of acute kidney injury (such as pre-existing chronic kidney disease, solitary or transplanted kidney, or suspected bilateral obstructing stones), or is dehydrated and unable to tolerate oral fluids due to nausea and/or vomiting.
• Imaging is also indicated when the diagnosis is uncertain to clarify the cause of symptoms.
• For most adults, low-dose non-contrast CT is the preferred imaging modality; however, for pregnant women, ultrasound is offered instead to avoid radiation exposure.
• For children and young people, ultrasound is the first-line imaging, with low-dose non-contrast CT considered if ultrasound results are inconclusive.

These imaging indications help confirm diagnosis, guide management decisions, and identify anatomical or medical conditions associated with recurrent stones.

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