renal calcifications

Question 1

what are the aka for kidney stones?

Answer 1

renal calculi
nephroliths
nephrolithiasis
uroliths
urolithiasis

Question 2

where are renal calculi located?

Answer 2

collecting system (pelvico-calaceal)

Question 3

how do renal calculi appear on plain film?

Answer 3

80-90% opaque, usually seen by the naked eye

Question 4

what do renal calculi look like?

Answer 4

small, homogeneously dense structures that are round, oval or irregular in shape often with a peak

Question 5

where will you see renal calculi on a lateral film?

Answer 5

overlying the spine, often over the arch OR the posterior aspect of the vertebral bodies

Question 6

urinary calculi that remain in the Kd are not usually painful unless?

Answer 6

they obstruct

Question 7

what type of pain is common with urinary calculi?

Answer 7

LBP

Question 8

what are staghorn calculi and why are they called that?

Answer 8

calcium fills the caylces and renal pelvis and it resembles the horn of a stag, thus “staghorn calculi”

Question 9

what calculi renders the kidney non-functional, is painful and often presents with blood in the urine?

Answer 9

staghorn calculi

Question 10

are ureteral calculi visible?

Answer 10

YES 80-90% visible

Question 11

what do ureteral calculi look like?

Answer 11

homogenous, oval or irregular in shape

Question 12

what is the size of most ureteral calculi?

Answer 12

1-3mm, occasionally can be 5mm

Question 13

where are 3 common locations for ureteral calculi to obstruct?

Answer 13

1 L1-L3 paraspinally at the pelvicoureteral junction
2 brim of the pelvis (ilium-sacrum)
3 within 1” of ischial spine superiorly at the vesicoureteral junction* MC location

Question 14

how do you differentiate between a phlebolith and a ureteral calculi?

Answer 14

most phleboliths are below the ischial spines and won’t move much on future films

Question 15

what can obstruction from a ureteral calculi cause?

Answer 15

pain and hydronephrosis

Question 16

what percent on ureteral calculi pass spontaneously?

Answer 16

93% within 3-4 days

Question 17

what is bladder calculi aka?

Answer 17

vesical calculi

Question 18

what percent of vesical calculi are seen on plain films and are they usually large or small?

Answer 18

80-90% usually large, small usually overlooked

Question 19

what is hydronephrosis?

Answer 19

excess fluid in Kd caused by back up of urine

Question 20

what do vesical calculi look like?

Answer 20

round, oval or stellate (jackstone)

Question 21

what are the MC causes of vesical calculi?

Answer 21

urinary stasis MC and infection

Question 22

what population is most effected by vesical calculi?

Answer 22

elderly 98%

Question 23

where are vesical calculi typically located?

Answer 23

in suprapubic region close to the midline

Question 24

what would cause vesical calculi to be positioned higher or more lateral?

Answer 24

prostatic hypertrophy or mass in the bladder (carcinoma)

Question 25

can vesical calculi cause obstruction or irritation?

Answer 25

duh

Question 26

what are nephrocalcinosis?

Answer 26

small clumps of stippled (punctuated) calcifications in the kidney parenchyma

Question 27

what is the location of a nephrocalcinosis?

Answer 27

95% medullary

5% cortical

Question 28

are nephrocalcinosis unilateral or bilateral?

Answer 28

bilateral and widespread