Presentation
Hematuria
Patient Data
Age: 40 years
Gender: Male
From the case:
Medullary sponge kidney on IVP

Ectatic distal collecting ducts and also dilated contrast filled intrapapillary tubules within the renal medulla are seen on intravenous pyelogram.
A case of Prof Saeed Rad, Tabriz, Iran.
Case Discussion
The intravenous pyelogram shows ectatic distal collecting ducts containing the microcalcifications, forming the bouquet of flowers appearance. If you look closer there are also dilated contrast-filled tubules within the renal medulla which is known as the paintbrush appearance. These findings are characteristic for medullary sponge kidney (MSK) on an intravenous pyelogram.