Calcifications I Flashcards
where is normal calcification in structures seen
-costal cartilages
-mesenteric lymph nodes
pelvic vein clots (phleboliths)
prostate gland
what are abnormal calcification locations
pancreas renal parenchymal tissue blood vessels gallbladder vas deferns
what are the 4 major patterns of calcifications
- concretions/calculi (stones)
- Conduit wall (tube structure)
- Cyst wall
- solid mass
concretion (stone) apperence (shape, borders, internal appearance)
shape- round/oval/faceted
borders- sharp, well defined, continuous/uninterupted
Internal app- laminated, homogenous
concretion types
gallbladder (gallstones) urinary tract diverticulum pelvic veins (phleboliths) pancreas prostate
What is a phelbolith, mc loc and management
deposits of calcium within wall of vein
common in pelvic area (generally asymptomatic, no need for follow uo)
how to differential phlebolith from ureter caliculi
if depends bellow ischial line prob not ureter calculi
what is a fecolith/appendicolith and where is it found/why
stagnent feces
seen in 10% of acute appendicitus
seen in 1/3 of removed appendices
(risk of rupture/surgerical removal)
gallstones (two types and pt it presents in)
cholesterol or bile
mc in women over 40
4Fs (female, fat, forty,fertile)
80% asymptomatic
risk factors of cholelithiasis
hemolytic anemoa
liver cirrhosis
diabetes
organ transplant
cholelithiasis imaging choice and tx
Ultrasound isn preferred
tx- surgery
What is gallstone ileus
gallstone in ileocecal valve leads to multiple loops of stacked small bowel distention
What is milk of calcium and how will it look
Sequele of cholecystitis
calcified biliary sludge within lumen of gallbladder
(gallbladder will be outlines
what are the two main kidney calcification pattens and what do they mean
Nephrolithoasis- Intralumental (stone)
Nephrocalcinosis- intraparenchymal (in parenchymal tissue)
imaging signs of nephrolithiasis vs nephrocalcinosis
nephrolithiasis- dense cal near central region
Nephrocalcinosis- Small rounded stones around parenchyma
Nephrocalcinosis pres + signs
medullary> cortical
Usually bilaterally
no early symptoms
similar symptoms to kidney stones (fever, pain nausea)
what can nephrocalcinosis lead to
later may develop kidney failure
Nephrocalcinosis tests + referal
Abdominal CT/US
Lab- Serum calcium, phosphate, uric acid and parathyroid hormone increased
Urinary calculi près and symptoms
intraluminal solid particles within the urinary system
symptoms: pain, nausea, commuting
check for blood in urine
Nephrolithesis symptom referral pattern
pain referral pattern flank into the abdomen and later the groin
Nephrolithiasis risk factors
Fam hx
UTI
kidney disorders
hyperparathyroidism
urinary calculi dx tests + tx
xray, CT
tx- h20, analgesics, antibiotics, surgery
Nephrolithiasis imaging pres
85-90% contain calcium
retroperitoneal loc
risk of obstruction
What is a stag horn calculus and what does it look like
large branching calculi
located in pelvicalyceal system (won’t pass)
Why do staghorn calculi form and symptos
commonly struvite forms in high Ph urine
more common in women
ss- fever, flank pain, hematuria
tx of stag horn calculi
- referal to nephrologist*
- entire stone must be removed *surg)
- if untx leads to chronic kidney inf and may result in pyelonephritis
Bladder calculi look and causes
smooth/irregular edges (usually a bit bigger
- urinary bladder outlet obstruction (mc)
- Recureent bladder inf
- Neurogenic bladder
- foreign bodies
bladder calculi symptoms
asymptomatic to painful
dysuria, frequency, hesitation, hematuria
tx- surgical removal
Who are prostatic calculi common in
> 40
overlie symphysis pubis
hx of prostatic
