Presentation
Flank pain.
Patient Data
Delayed right nephrogram, where there is notably increased corticomedullary differentiation when compared to the left kidney. The right kidney is also mildly enlarged with mild hydronephrosis. This is due to a 3 to 4 mm stone at the pelvoureteral junction. No other urolithiasis or other acute findings. Hepatic steatosis.
Case Discussion
This is a basic teaching case that illustrates the value of assessing differential renal enhancement to help focus your review. In this case, the right renal enhancement is delayed when compared to the left kidney, also referred to as a delayed nephrogram, which indicates increased pressures due to ureteral obstruction which results in relatively decreased perfusion. This can be helpful to directly review to carefully assess for smaller stones, which was the cause in this case.
Unable to process the form. Check for errors and try again.