Medullary nephrocalcinosis and renal calculi

Case contributed by Dr Bruno Di Muzio

Presentation

26 years-old female with right pain that tends to radiate to the flank and lumbar areas.

Patient Data

Age: 23
Gender: Female
Ultrasound

Ultrasound

Increased echogenicity of the pyramid and renal calculus in the right kidney (Portuguese: "Rim Direito").

 

Case Discussion

Ultrasound demonstrates a large upper pole echogenic focus with posterior acoustic shadowing consistent with a renal calculus. The pyramids are diffusely echogenic, but without shadowing, consistent with medullary nephrocalcinosis

Although nephrocalcinosis may eventually progress to involve most of the pyramid, acoustic shadowing is rarely seen even in this situation.

Acoustic shadowing may be appreciated only in rare cases of extreme involvement of the pyramids or if there is development of associated calculi in the adjacent calices, like in this case.

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Case information

rID: 12141
Case created: 24th Oct 2010
Last edited: 16th Aug 2016
System: Urogenital
Inclusion in quiz mode: Included

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