Ultrasonic detection of nonopaque renal calculi

Four patients with 5 nonopaque renal calculi composed of uric acid were examined by ultrasound. The calculi varied in size from a 1.5 X 1.5-cm intrapelvic stone to a staghorn calculus measuring 4 cm. All stones were satisfactorily imaged by ultrasound, allowing a diagnosis of nephrolithiasis to be made with confidence in each case. In 2 patients with poor excretion on urography, the diagnosis was not suspected prior to the ultrasound examination. The authors feel that ultrasound has great potential value in the investigation of nonopaque filling defects of the renal pelvis and in patients with urographic nonvisualization who have a high risk of uric acid lithiasis.