Vesicoureteric junction and renal calculi: the value of twinkle artifact

Case contributed by Brendan Cullinane
Diagnosis almost certain


Left sided abdominal pain.

Patient Data

Age: 60 years
Gender: Male

Left vesicoureteric junction (VUJ) stone creating a twinkle artifact; there was no evidence of this calculus with B-mode imaging.

Left renal caclulus: a small, markedly echogenic region is seen in the lower pole with B-mode imaging. No soft or hard shadowing was demonstrated. The use of color Doppler produced twinkle artifact posterior to this area identifying a small calculus.

The collecting system and ureter were not dilated, suggesting that the VUJ calculus was non-obstructive.

Case Discussion

Non-obstructive left VUJ and left renal calculi were demonstrated using color Doppler to generate the twinkle artifact. These stones were confirmed with CT (not shown).

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.