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Lying down adrenal sign

Last revised by Dr Sonam Vadera on 15 Nov 2021

The lying down adrenal sign is a cross-sectional imaging sign of renal agenesis or ectopia in which the ipsilateral adrenal gland appears to be 'lying down' on the psoas muscle posteriorly. Due to the linear as opposed to Y-shaped configuration of the gland in such situations, it is also described as the discoid 1, straight 2, elongated 2, or pancake adrenal gland 3,4

It can be a useful sign to confirm renal agenesis when the kidney is not visualized during antenatal ultrasound 5,6, as well as during postnatal imaging of patients to distinguish from postnephrectomy state.

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Cases and figures

  • Case 1
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  • Case 2: left
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  • Case 3: right
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  • Case 4: right
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  • Case 5: left
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  • Case 6: right
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  • Case 7: lying down adrenal sign due to pelvic kidney
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