Fibromuscular dysplasia (right renal artery)

Case contributed by Dr Chris O'Donnell

Presentation

Refractory hypertension despite maximal medical therapy.

Patient Data

Age: 45
Gender: Female
Modality: Ultrasound

Localized gross turbulence and increased peak systolic velocity to 600 cm/sec in the proximal right renal artery (with normal origin and more distal renal artery profiles).

Left renal artery has normal flow velocities.

CT angiography performed to confirm the duplex ultrasound findings

Modality: CT

Typical "beaded" appearance to the right renal artery as seen in fibromuscular dysplasia. Note that the right kidney is a little smaller than the left and that the left renal artery is normal as are other branches of the abdominal aorta.

Case Discussion

Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory vascular disease that causes abnormal growth within the vessel wall. It can involve the intima, media or adventitia.

The medial type is characterized by thickening of the media with collagen formation. It accounts for the vast majority of cases.

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Case Information

rID: 31157
Case created: 21st Sep 2014
Last edited: 9th Nov 2015
Inclusion in quiz mode: Included

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