Horseshoe kidney

Case contributed by Dr Laughlin Dawes

Presentation

Recurrent UTI

Nuclear medicine

Tracer uptake into both left and right kidneys. Tracer is also demonstrated between the two kidneys in an isthmus of a horseshoe kidney.

Case Discussion

Horseshoe kidney is the most common type of renal fusion anomaly. It is formed by 2 distinct functioning kidneys on each side of the midline, connected by an isthmus (bridge) of functioning (this case) renal parenchyma or fibrous tissue that crosses the midline of the body. The fusion is typically between the lower poles (90%). Consequently the inferior poles point medially, which is the reverse of the normal renal axis. The incidence is approximately 1 in 500.

Complications of a horseshoe kidney include:

  1. hydronephrosis (due to UPJ obstruction)
  2. infection
  3. calculi
  4. increased incidence of malignancy (Wilms, transitional cell and carcinoid tumours)
  5. increased susceptibility to trauma
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Case information

rID: 35857
Case created: 24th Apr 2015
Last edited: 21st Sep 2017
System: Paediatrics
Inclusion in quiz mode: Included

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