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Related Experiment Video

Updated: May 17, 2026

A Protocol of Manual Tests to Measure Sensation and Pain in Humans

A Protocol of Manual Tests to Measure Sensation and Pain in Humans

Published on: December 19, 2016

No pain, no pathology?

Devesh Sharma¹, Abha Govind

¹Department of A&E Medicine, Frimley Park Hospital, Camberley, UK. devesh.sharma@fph-tr.nhs.uk

BMJ Case Reports

|October 30, 2012

Summary

A young woman with a history of kidney issues experienced severe pain and vomiting due to a kidney stone. Prompt imaging revealed a ruptured calyx and obstruction, leading to urgent stent placement.

Area of Science:

Nephrology
Urology
Medical Imaging

Background:

A 22-year-old female with a history of reflux nephropathy and recurrent urinary tract infections presented with acute flank pain and emesis.
Initial management in the emergency department (ED) followed a pyelonephritis protocol, with admission to a short-stay ward.

Observation:

Despite initial clinical improvement, emergency department ultrasound revealed right-sided hydronephrosis and a fluid collection adjacent to the kidney.
Subsequent CT imaging confirmed renal tract obstruction and a ruptured calyx, identifying an 8 mm calculus as the causative agent.

Findings:

An 8 mm renal calculus was identified as the cause of acute renal tract obstruction.
The obstruction led to significant hydronephrosis and a ruptured calyx, necessitating urgent intervention.

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Implications:

This case highlights the importance of advanced imaging in patients with suspected pyelonephritis who do not fully resolve with initial treatment.
Prompt urological consultation and intervention, including cystoscopic insertion of a ureteral stent, are crucial for managing obstructive uropathy and preventing further renal damage.