STONE Score for Uncomplicated Ureteral Stone
Predicts likelihood of ureteral stone in nontoxic-appearing patients with flank pain.
Use in patients with suspected kidney stones and normal renal function. Do not use in patients with fever or other signs of infection, recent trauma or urologic surgery, or active malignancy.
- May be used to facilitate shared decision-making with patients.
- Daniels et al (2016) showed that:
- For patients with low and moderate STONE scores, the presence of hydronephrosis on ultrasound increased the likelihood of kidney stone as diagnosis, with moderate/severe hydronephrosis increasing the likelihood more than mild hydronephrosis.
- For all levels of STONE score, hydronephrosis on ultrasound decreased the likelihood of a dangerous alternative diagnosis, and increased the likelihood of the patient having a urologic procedure within 90 days (total procedure rate: 30%).
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A high score can obviate need for an immediate CT scan, in healthy patients. If further imaging is warranted, a low dose CT scan may be more appropriate than a standard dose CT scan in these patients.
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A moderate score plus a finding of hydronephrosis suggests a high likelihood of a kidney stone and may also obviate the need for immediate CT scan in healthy patients.
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A low score should cause clinicians to consider alternative diagnoses but does not in itself necessitate a CT scan or other imaging. Over 75% of patients with a low score had non-diagnostic CT scans.