A 45-year-old male presents with severe, colicky pain originating in his right flank and radiating to the groin. The pain started suddenly a few hours ago. He also complains of nausea and has vomited once. What are the potential causes and next steps?
This patient's symptoms are highly suggestive of a kidney stone, particularly a ureteral stone, given the sudden onset, location, and nature of the pain. Next steps would include an abdominal CT scan without contrast, which is the most sensitive and specific imaging test for kidney stones. Symptom management with analgesics, antiemetics, and possibly medical expulsive therapy with alpha blockers would also be indicated.