Lecture 16: Radiology of the renal tract Flashcards
On plain film how do kidney stones present?
There are radio-opaque (calcified) and non-radio-opaque stones (i.e uric acid)
What are renal stones divided into?
Calcified (radio-opaque)
Non-calcified (i.e non radio opaque) i.e uric acid
Where are the ureters located on an x-ray?
In line with the transverse process
What is ultrasound useful for in the renal system?
Detecting:
- Renal stones, renal obstruction, renal mass and bladder lesions (cannot assess ureters)
- Can detect non-calcified renal stones
What is found in the central renal complex?
Vessels, fat, fibrous tissue
What is CT useful in renal imaging?
Stone, Tumour, Trauma, Infection
What is MRI useful for and not useful for in renal imaging?
- Useful for soft tissues abnormality, renal tumour, infection
BUT Takes a long time thus inability to stay still can ruin the image acquisition (and kidney stones are very painful)
How does the age of a pt influence renal imaging?
- Antenatal
- Pediatrics
= Ultrasound or MRI, never radiation - Adult
= Different clinical concerns, different radiation issues
Young 25 Y/O man presents with left flank radiation to the groin, haematuria, no fever, normal WCC.
What is the likely diagnosis? How do you image?
Renal colic
Image using CT if no stone is present on xray
What is renal colic?
Describes a syndrome of severe abdominal pain, radiating loin to groin
Difficulty lying still, writhing in pain.
42 Y/O woman with right flank pain, fever, high WCC
What is the likely diagnosis, what imaging would you use? What lab tests?
Fever + High WCC = Infection
Urine, blood test to confirm
Ultrasound to image the kidney
Elderly 85 y/o man with recurrent UTI
Likely diagnosis, imaging test and lab test?
Likely diagnosis -> Benign prostate hyperplasia
Imaging test -> Ultrasound
22 y/o decreased renal function (Decreased GFR, High urea and creatinine)
Likely diagnosis, imaging test, other questions?
AKI
-> History and examination, Ultrasound
25 y/o man crashed his MTB in the forest:
What clinical information do you want?
What imaging test? Whats a consideration?
Check for external bruising, head+neck+chest trauma, blood in urine
Understand that bleeding will be reteroperitoneal and might not present in the abdomen
Whats the white stuff in the kidney?
Whats happening here?
Whats the dark stuff in the left kidney?
FAT
Whats happening here?
Whats happening here?
Whats happening here?
Whats happening here?
Polynephritis of right kidney + Abcess
Whats happening here?
Benign prostatic hyperplasia
Whats happening here?
Whats happening here?
Traumatic injury if the right kidney with blood in the abdomen
