Prostate Calculi Causing Crepitus on Physical Exam

Crepitus on digital rectal examination is a rare physical exam finding, but can be clinically concerning in a patient with infective symptoms and may prompt extensive workup for severe infection with a gas-forming organism. Historical urologic literature suggests that this finding typically relates to large prostatic calculi, however. Here we present a case of significant prostatic stone burden in a symptomatic patient causing crepitus in the prostate on physical exam.