Presentation
Fall with right hip pain.
Patient Data
Multiple sclerotic bone metastases throughout the imaged skeleton - patient had a known history of prostate cancer with metastases. Right hip hemiarthroplasty, no periprosthetic fracture or loosening. No obvious fracture.
Large spiculated Jackstone bladder calculus within the urinary bladder. Urinary catheter in situ.
Multiple sclerotic metastases throughout the pelvis, lumbar spine, and both proximal femora in keeping with known metastases from primary prostate cancer.
Right hip prosthesis creates a significant metallic artifact. No fracture was seen.
Intravesicular jackstone calculus within the bladder.
Case Discussion
Jackstone calculi have a unique spiculate starry appearance - named after the children's game of 'jacks' which use objects of a similar appearance. These form almost exclusively in the bladder as they occur in situations of urinary stasis. However, there have been cases of these forming in the renal pelvis/upper urinary tract. Outflow obstruction is often the most important causative factor which leads to urinary stasis allowing matter within the bladder (such as calcium oxalate dihydrate) to aggregate and form stones. In this particular case, the patient had known prostate cancer causing a degree of outflow obstruction, thus predisposing him to jackstone calculi formation.
Often, these patients are treated via fragmentation of the calculus through lasertripsy or lithotripsy, before a cystoscopic or open cystolithotomy is used to remove fragments.
Unable to process the form. Check for errors and try again.