Perinephric stranding

Case contributed by Dr Matt A. Morgan


Presents with left costovertebral angle tenderness.

Patient Data

Age: 70 years
Gender: Male

Single axial and coronal images showing a large amount of perinephric stranding around the left kidney. The kidneys enhance normally. There is no hydronephrosis.

Annotated image

A red circle is drawn around the kidney showing perinephric stranding.

Zoomed in images are also provided.

Case Discussion

Perinephric stranding is a nonspecific sign pointing to an underlying inflammatory problem with the kidney and/or collecting system.

Depending on the situation, it could result from

  • pyelonephritis (usually heterogeneous enhancement in the ipsilateral kidney)
  • urolithiasis (usually ipsilateral collecting system dilatation)
  • trauma (extravasation into the perinephric space... need appropriate history and/or hematoma, renal laceration)
  • renal lymphoma (usually associated with appropriate history, heterogeneous enhancement, renal mass(es), or nephromegaly)

A small amount of perinephric stranding is also considered normal as a patient ages ("kidney sweat")

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Case information

rID: 42491
Published: 23rd Jan 2016
Last edited: 14th Aug 2019
System: Urogenital
Tag: kidney
Inclusion in quiz mode: Excluded