Presentation
Vague abdominal pain.
Patient Data
The main finding here is a soft tissue mass in the right paravertebral region, replacing the normal contour of the right kidney. On the left side, a normal renal shadow can be seen but on the right side it appears more dense, and the renal pelvis is not clearly seen. There is no calcification, no bone destruction and the bowel appears normal.
The CT confirms a large mass arising from and almost replacing the right kidney. There is loss of the low density structures within the kidney, i.e. the fat and the fluid in the pelvis, accounting for the high density on the plain film.
Case Discussion
Use the "ABDO X" system when analyzing abdominal x-rays. Although abdominal x-rays are not sensitive enough to be used as a primary modality to interrogate abnormalities of the solid viscera, abnormalities may nonetheless be picked up with careful analysis. In this case, the normal outline and contour of the right kidney has been lost indicating pathology in this region.