Horseshoe kidney with bilateral hydronephrosis. The dilated pelvis bilaterally is suggestive of pelviureteric junction obstruction or upper ureteric strictures, evident on right kidney with subsequent right renal atrophy.

Horseshoe kidney remains asymptomatic until incidentally discovered or develop complications. One of the commonest complications is hydronephrosis, usually due to pelviureteric junction obstruction.