Which imaging technique is considered the gold standard for diagnosing nephrolithiasis?

The computed tomography (CT) scan is regarded as the gold standard for diagnosing nephrolithiasis, primarily because it provides a detailed and accurate visualization of renal stones. CT scans are effective at identifying even small stones, as they can detect calcifications and differentiate between stones and other potential causes of abdominal pain. This imaging modality is sensitive and specific, allowing for precise diagnosis, which is crucial in guiding appropriate management plans.

Moreover, a CT scan is fast and does not require the use of contrast media, making it a valuable tool in acute settings where rapid diagnosis is essential. In contrast, while ultrasound is a non-invasive technique and useful in specific patient populations, like pregnant women or children, it may not always detect smaller stones due to limitations in resolution. X-rays can show certain types of stones, particularly those that are radiopaque, but not all stones are visible on standard X-rays, which decreases their utility as a definitive diagnostic tool. MRI, though excellent for soft tissue evaluation and avoiding radiation, is not typically used for detecting kidney stones due to its lower sensitivity in this context and longer examination time.