Presentation
Presents with left costovertebral angle tenderness.
Patient Data
Single axial and coronal images showing a large amount of perinephric stranding around the left kidney. The kidneys enhance normally. There is no hydronephrosis.
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")