Bilateral cortical nephrocalcinosis
Bilateral loin pain
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- Thin rims of dystrophic calcification seen at the outer margins of the renal cortex (tramline), which extend into the medullary spaces along the column of Bertin on the left side.
- no CT evidence of urolithiasis or back-pressure changes.
- the revised bone window clearly illustrates the calcifications.
- the above described features are suggestive of bilateral cortical nephrocalcinosis with the typical appearance of thin rims of dystrophic calcification which may be deposited at the inner and outer margins of the renal cortex as a result of a major vascular insult that produces cortical necrosis, or rarely, as a consequence of glomerulonephritis, hyperoxaluria, and Alport syndrome, with the development of cortical nephrocalcinosis.
- The pattern of parenchymal calcification is said to resemble a tramline or railroadtracks or less likely two thin parallel calcified tracks or multiple punctuate calcifications in random distribution (least common).
there is no correlation between the pattern of calcification and a specific cause
- causes of cortical nephrocalcinosis can be remembered by the mnemonic:
A: Alport syndrome
G: (chronic) glomerulonephritis
- 1. Raymond B. Dyer, Michael Y. Chen, Ronald J. Zagoria. Classic Signs in Uroradiology1. (2004) RadioGraphics. 24 Suppl 1: S247-80. doi:10.1148/rg.24si045509 - Pubmed
- 2. Schepens, Dirk, Verswijvel, Geert, Kuypers, Dirk, Vanrenterghem, Yves. Renal cortical nephrocalcinosis. (2000) Nephrology Dialysis Transplantation. 15 (7): 1080. doi:10.1093/ndt/15.7.1080