Left ureteric calculus

Case contributed by Andrew Dixon
Diagnosis almost certain

Presentation

Presents with left loin pain to groin. Query renal calculus. Past history renal calculus.

Patient Data

Age: 60 years
Gender: Male
ct

Within the left distal ureter, just proximal to the vesicoureteric junction, there is a 6 x 5 x 5 mm calculus. This is associated with mild left hydroureter and left hydronephrosis, and mild left perinephric stranding. Three small nonobstructing calculi are seen within the left kidney, measuring 3 mm at the upper pole, 2 mm at the lower pole and 4 mm at the lower pole. No right-sided renal calculus identified. Two low density lesions in the liver, measuring 2.6 cm in segment 2/3 and 2.2 cm in segment 6/7, likely represent cysts. Diverticular disease of the sigmoid colon.  No dilated loops of small or large bowel.

ultrasound

Mild left hydronephrosis. Near the left VUJ, there is a 6mm echogenic focus producing posterior shadowing consistent with a calculus. Only the right ureteric jet was visualized. 

Case Discussion

Typical CT and ultrasound appearance of ureteric colic. While non-contrast CT is typically more sensitive for visualizing a ureteric stone than ultrasound, the latter test avoids the need for ionizing radiation and can reliably demonstrate features of obstruction (hydronephrosis, absence of a ureteric jet on color Doppler) even if the stone itself is not seen.  

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.