Case contributed by Dr Ian Bickle


Peristent hematuria and left loin pain. Left hydronephrosis on ultrasound.

Patient Data

Age: 55 years
Gender: Male

Multiple stones of varying size in the distal left ureter - the largest at the VUJ.

Left sided hydronephrosis.

Annotated image

The stacked up stones in the distal ureter resemble a cobbled stone street ( steinstrausse )

Case Discussion

Urolithiasis is common - with a significant component of this being ureteric stones.

Within this subset, the accumulation of numerous stones stacked up in the ureter is more unusual.

Typically the larger stone is the most distal, with the smaller stones stacking up proximally - the multiplicity may only be appreciated on 'windowing' of the CT-KUB study.

This appearance has been labeled as steinstrasse ( cobbled street ) due to its visual resemblance.

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Case information

rID: 38025
Published: 6th Jul 2015
Last edited: 31st Aug 2020
System: Urogenital
Inclusion in quiz mode: Included