Presentation
Right abdominal pain.
Patient Data
Horseshoe kidney and right side back pressure changes.
Bilateral calcific densities near the vesicoureteric junctions. Right calcific density (red arrow) is completely surrounded by a soft tissue density rim consistent with a ureteric stone surrounded by an edematous ureter wall (soft tissue rim sign). The left calcific density (green arrow) cannot be a ureteric stone as it is completely surrounded by fat density and it is therefore a phlebolith.
Case Discussion
Patient with horseshoe kidney. Right sided hydronephrosis and hydroureter with perinephric and periureteric fat stranding. Bilateral calcific densities near the vesicoureteric junctions. One right calcific density is completely surrounded by a soft tissue density rim consistent with a ureteric stone surrounded by an edematous ureter wall (soft tissue rim sign). The other calcific densities are phleboliths that are surrounded by fat instead of soft tissue.
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