Vesico-ureteric junction stone

Case contributed by Dr Ali Basim

Presentation

Left flank pain.

Patient Data

Age: 35 years
Gender: Female
Ultrasound

There is a stone at the left vesico-ureteral junction (VUJ) with dilated left ureter and left pelvicalyceal system. An acoustic shadow and twinkling artifact in the stone are evident.
Normal ureteric jet of the right ureter is demonstrated by color doppler.

Case Discussion

The stone obstructing the VUJ is well seen by ultrasound in this case. It results in dilatation of the pelvicalceal system and the ureter in the left side .The ureter is seen dilated at its proximal part and its distal part, posterior to the bladder .

  • the stone shown as echogenic focus in greyscale (B-mode) with a posterior acoustic shadow
  • when color Doppler is used, a twinkling artifact is produced by the stone

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