D’Costa MR, et al. - Among first-time symptomatic stone formers, researchers focused on the symptomatic and radiographic manifestations of kidney stone recurrence. They also intended to understand how these varied manifestations of recurrence are predicted by established risk factors. The participants were recruited from the general community in Minnesota and Florida. Following the first stone episode, recurrence was both more common and more predictable when all manifestations of recurrence (symptomatic and radiographic) were taken into account. At 5 years, radiographic evidence of stone passage (accompanied by symptoms in only 52%) was present in 51% of those with a baseline asymptomatic stone (54%). Findings revealed a more strong association of imaging evidence of a new stone or stone passage, with symptomatic recurrence found by clinical care vs by self-report.