Uric acid stones

- Uric acid renal stones develop in patients with chronic gout due to hyperuricosuria,
 

- Uric acid stones present with loin pain radiating to the flanks, hematuria, and history of previous attacks of gouty arthritis or hyperuricemia.

- Uric acid stones are RADIOLUCENT and don't appear on X-ray, so for diagnosis CT scan (without contrast) is required.

- Management:

It's mandatory to start with adequate hydration, analgesics and pain killers.

Also you have to add either Potassium Citrate or alkalization of urine using Potassium bicarbonate; you have in general to avoid alkalization of urine with sodium bicarbonate in order to prevent formation of calcium stones.

Renal stones less than 2 cm are treated with Extra-Corporeal shock wave lithotripsy (ECSWL), multiple or stones greater than 2 cm in size should undergo per-cutaneous extraction.