Snapshot A 48-year-old woman presents to the emergency department due to severe back pain. Her symptoms began approximately 3 hours ago and says the pain is in her left mid-back. She describes the pain as sharp and 9/10. The pain radiates to her left groin. On physical exam, there is left-sided costovertebral angle tenderness. A non-contrast computerized tomography (CT) scan of the abdomen demonstrates left-sided urolithiasis and hydronephrosis. She is started on a nonsteroidal antiinflammatory drug (NSAID) and intravenous normal saline. (Nephrolithiasis resulting in hydronephrosis) Introduction Clinical definition login to view 2 more bullets Epidemiology login to view 6 more bullets Etiology login to view 12 more bullets hydronephrosis Pathogenesis login to view 8 more bullets Prognosis login to view 1 more bullet Presentation Symptoms login to view 4 more bullets Physical exam login to view 3 more bullets Imaging Renal ultrasonography login to view 2 more bullets Computerized tomography (CT) scan of the abdomen login to view 2 more bullets Studies Labs login to view 5 more bullets Differential Pyelonephritis Peripelvic cyst Calyceal diverticula Treatment Conservative login to view 5 more bullets Treatment ultimately depends on the underlying cause of hydronephrosis login to view 1 more bullet Complications Postobstructive diuresis