Questionnaire/history: Abrupt onset of severe unilateral abdominal pain? - Originating in the loin or flank? - Radiating to the labia in women or to the groin or testicle in men? - Lasting for minutes to hours? - Spasms with intervals of no pain or dull ache? - Duration? - Severity? ----- Most severe pain experienced? - Exacerbating factors? - Relieving factors? Associated symptoms: - Nausea/vomiting? - Haematuria? - Dysuria? - Urinary frequency? - Straining? Risk factors? Past medical history (eg immunosuppression)? Current medication? Drug allergies? Examination: Restless and unable to lie still (different from peritonitis)? Signs of complication? - Hesitancy of micturition or intermittent urinary stream (suggesting urinary tract obstruction)? - Fever and sweats (suggestion coexisting urinary tract infection)? Urine dipstick? - Haematuria? - Nitrite +/- leucocyte esterase? Management Reference(s): NICE CKS: Renal or ureteric colic - acute Information for patient/carer(s): NHS Health A to Z: Kidney stones Patient UK: Kidney stones