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Kenneth Krayenhagen
Judy Bhatti
Elissa Twist


Nephrolithiasis, Mechanical Back Pain, Referred Pain


Objective : This case report serves to describe an unusual presentation of nephrolithiasis. Often this condition can mimic mechanical back pain. The clinician may treat it as such and be fooled by short-term remission of symptoms.

Clinical Features: A 63 -year-old female who had been successfully treated for the prior 3 weeks for low back pain (LBP) and sacral-iliac joint pain (SJP) with chiropractic treatment subsequently came withl mid-thoracic pain. The presentation suggested mechanical back pain. During the examination, her pain was increasing and becoming more colicky in nature. She was sent for a series of x-rays. A KUB (Kidney, Ureter, Bladder) radiograph revealed a 2.6 cm (about 1.02 in) calcification within the left renal system.

Intervention and Outcomes: She was referred to a urologist for CT scan and required surgery. Post-surgery, her pain subsided.

Conclusion: This case demonstrates that nephrolithiasis can imitate mechanical lesions with the LBP and SJP. Since visceral and mechanical back pain share some common symptoms, it is easy to miss the diagnosis. Clinicians should always consider referred pain of visceral origin until it is ruled out. Chiropractors should consider abdominal radiographs if visceral origin of back pain is suspected.


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