Ureteral reflux: grade 4
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Grade 4 vesicoureteral reflux on right side.
There is a duplicate right ureter that fuses just before entering the bladder. This is only appreciable on the early images, as later on the bladder contains too much contrast to provide a clear view.
This study illustrates the need for performing a dynamic study, the main reason being that reflux may only be visible at specific moments.
Also the fusion of the duplicate right system may not have been visible when no early images were acquired. Furthermore, coronal and lateral images can complement each other as coronal images will show the side of abnormalities, whereas lateral images provide a better view of the most distal ureter.