Lying down adrenal sign

Last revised by Sze Yuen Lee on 20 Apr 2023

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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