Important Dd(x) of urolithiasis or renal colic

1) Abdominal aortic aneurysm

- Beware of the patient age > 60 years old presented with first episode of renal colic

- Rule out AAA first before diagnose urolithiasis

- look for pulsatile abdominal mass

- Bedside ultrasound if available

2) Acute appendicitis

- Alvarado score may be helpful to rule out appendicitis

3) Urinary tract infection with urolithiasis

4) Pyonephrosis/ Pyleneprosis

5) Renal artery embolus

6) Testicular torsion

- Particularly in younger age patient especially late teenage age.

7) Others uncommon causes like bowel obstruction, Infective gastroenteritis, Acute urinary retention, obstructed inguinal hernia, orthopedic problem, abdominal abscess, epididymitis, orchiditis, acute pancreatitis.