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Renal tubular ectasia

Case contributed by Matt A. Morgan
Diagnosis almost certain

Presentation

History of a single episode of urolithiasis. Currently asymptomatic. Evaluation as per request of urology.

Patient Data

Age: 50 years
Gender: Female
Fluoroscopy

There are no calcifications in either kidney. A recent CT of the abdomen and pelvis (within a month) did not show any renal stones.

On IVP, there is exaggerated "strandy" enhancement of the medullary pyramids with a "paintbrush" appearance. No filling defect is seen in either kidney.

Case Discussion

The appearance is compatible with renal tubular ectasia. This "paintbrush" appearance overlaps with medullary sponge kidney, and the difference between the two is really one of degree and symptoms.

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