Presentation
Flank pain and hematuria in a patient with gout. Plain film KUB is normal.
Patient Data
Within the right renal pelvis a hyperdense focus is present with an oblong form on axial and a more rectangular form on coronal imaged. There is no hydronephrosis or hydroureter although the proximal right ureter is swollen with some surrounding stranding. The left collecting system is unremarkable.
Oblong calculus is located in the right renal pelvis (blue dotted line) with stranding of the proximal ureter (yellow arrow).
Case Discussion
Uric acid stones are uncommon, and are radiolucent on plain films. They typically have a sheet like / oblong morphology.