Soft tissue rim sign - ureteric stone

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Right abdominal pain.

Patient Data

Age: 30 years
Gender: Male

Renal Colic CT

ct

Horseshoe kidney and right side back pressure changes.

Soft tissue rim sign

Annotated image

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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