A 42-year-old man without a history of kidney stones had intermittent left flank pain for several weeks before being seen by his primary care doctor. Urinalysis revealed microhematuria. Computed tomography (CT) of the abdomen and pelvis without contrast enhancement identified a calcification 12 mm in diameter in the left renal pelvis, associated with mild hydronephrosis and a normal-caliber ureter. The attenuation coefficient of the stone was 790 Hounsfield units, and the skin-to-stone distance was 8.5 cm. He was referred to a urologist, who reviewed the CT scan and recommended treatment with extracorporeal shock-wave lithotripsy.
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