Right flank pain & hematuria

Cheif Complaint A 62 y/o male presents with dull right flank pain, hematuria & dysuria. Vitals BP: 140/90 mmhg, Respiratory rate: 19 breaths/minute, Pulse: 76 beats/minute, Temp: 98.4 degree F. History Patient is diabetic and hypertensive. Past surgical history normal. Investigations SCr=1.33, Calcium, & LDH all other labs were normal. CT scan is posted. What other investigations should be followed? Diagnosis Please give your valuable opinion. Treatment Comment on the treatment as well.

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Only one slice of ct is difficult to interpret. Flank pain generally denotes pain originating from pelvis, some times from kidney. Hematuria also supporting that pathology is in genito urinary system. Look for stone, tumour. Exclude uti too.check urine for types of haematuria, abnormal cell and pus cell and cs. Though dysuria is uncommon in renal pathology like tumour but can occur if clot causing obstruction of tract.

@Yogesh Varma Sometimes kidney stone pain starts as a dull ache, but it can quickly escalate to severe cramping or sharp, wincing pain. You usually feel it in your back or side, underneath your rib cage. The pain can radiate into your lower abdomen or groin. Ruled out Kidney stone Urine examination

Lt. Kidney shows increase in irregular echotexture with multiple renal stone ?? Metastasis

renal calculi

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