Metabolic stones and other stories . . .

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h95 (Published 14 January 2015) Cite this as: BMJ 2015;350:h95

On 26 March 1658, Samuel Pepys was “cut for the stone” in London. Thankful to survive, he kept the day as a solemn festival for the rest of his life. Modern Londoners with stones can attend the University College and Royal Free hospitals’ metabolic stone clinic, where it is no longer standard practice to tie them down and plunge a knife through their perineum, insert a finger into the bladder, retrieve the stone, and show it to the surrounding public. A study of the clinic’s records (QJM 2014, doi:10.1093/qjmed/hcu251) from 1995 to 2012 showed that the prevalence of hypercalciuria, hyperoxaluria, and hyperuricosuria increased over time and that more women are tending to present with stones in the urinary tract—but seldom in the bladder.

Knee pain without trauma is common in adolescents and young adults. About a quarter of it is felt behind the kneecap and is classed as “prepatellar pain syndrome,” overlapping with the traditional “chondromalacia patellae.” Youngsters with …

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