Abdominal US requested due to elevated CRP two days later:
- Both kidneys (only right one shown) demonstrate a striking increase of medullary echogenicity (note partial distal acoustic shadowing).
- Moderately increased reflectivity of the cortex.
- With color Doppler the medullary pyramids demonstrate a marked, confluous twinkling-phenomenon due to severe calcification.
- Small, simple cortical cysts.