Most people are diagnosed with kidney stones after the thunderclap onset of excruciating and unforgettable pain. This severe pain occurs when the kidney stone breaks loose from the place that it formed, the renal papilla, and falls into the urinary collecting system. When this happens, the stone can block the drainage of urine from the kidney, a condition known as renal colic. The pain may begin in the lower back, and may move to the side or the groin. Other symptoms may include blood in the urine (hematuria), frequent or persistent urinary tract infections, urinary urgency or frequency, and nausea or vomiting.

When your doctor evaluates you for a kidney stone, the first step will be a complete history and physical examination. Important information regarding current symptoms, previous stone events, medical illnesses and conditions, medications, dietary history, and family history will all be collected. A physical examination will be performed, to evaluate for signs of a kidney stone, such as pain in the flank, lower abdomen, or groin.

Your doctor will perform a urinalysis, to look for blood or infection in the urine. A blood sample will also be collected so that kidney function and blood counts can be measured.

Even though all of these tests are necessary, a kidney stone can only be definitively diagnosed by a radiologic evaluation. In some cases, a simple x-ray, called a  KUB, will be adequate to detect a stone. If your doctor requires more information, an  intravenous pyelogram (IVP) or a CT scan may be necessary.

Sometimes kidney stones do not cause any symptoms at all. Such painless stones can be discovered when your doctor is looking for other things on x-rays. Sometimes, although a stone does not cause any pain, it can cause other problems such as recurring urinary tract infections or blood in the urine.