Presentation
Irrelevant to the context.
Patient Data
Markedly enlarged right kidney with dilated pelvicalyceal system down to the PUJ and thinned parenchyma. No stones or masses.
The findings were confirmed by ultrasonography which was carried out to exclude urinary stones.
Case Discussion
The young age and lack of any history of renal trouble suggest that the case is congenital PUJ obstruction.
Ideally this diagnosis should be confirmed with either an IVU or nuclear imaging study to dynamically confirm a PUJ obstruction.
When imaging the spine, one should review the visualized other organs, especially the localizers, to ensure no other abnormality is present. This is particularly the cases with dysraphism, in which congenital renal anomalies are a recognized association.