Urinary System - Part 4 Flashcards
Crossed fused
ectopia
Both kidneys are fused in the same quadrant
- 2 separate collecting systems
- 2 normally located adrenal glands
What the the clinical findings of crossed fused ectopia? (2)
- Asymptomatic
2. Abdominal mass
What is the US appearance of crossed fused ectopia? (3)
- One single, large kidney
- Irregular contour
- Inferior pole is directed medially
What are 3 differential diagnosis of crossed fused ectopia?
- Renal mass
- Cake kidney
- Sigmoid kidney
Duplication of the kidney
2 distinct collecting systems
- may involve kidney, ureter, and/or renal pelvis
- may be partial or complete
What are the clinical findings of duplication of the kidney? (2)
- Asymptomatic
2. Flank pain
What are the US appearance of duplication of the kidney? (3)
- Increase in renal length
- 2 distinct collecting systems
- The superior system is most likely to obstruct
What are 2 differential diagnosis of duplication of the kidney?
- Hypertrophied column of Bertin
2. Renal mass
Horseshoe kidney
Fusion of the kidneys usually at the inferior poles
What is the horseshoe kidney connected by?
Connected by an isthmus of functioning parenchyma or non-functioning fibrotic tissue
What is the most common form of renal fusion?
Horseshoe kidney
What are the clinical findings of horseshoe kidney? (2)
- Asymptomatic
- Pulsatile abdominal
mass
What is the US appearance of horseshoe kidney? (4)
- Bilateral low lying medially placed kidneys with partial or complete fusion of the inferior poles
- “Dipping effect” of both inferior poles
- Isthmus of tissue demonstrated anterior to the abdominal aorta
- Isthmus echo texture is similar to the renal cortex
What are 4 differential diagnosis of horseshoe kidney?
- Renal mass
- Lymphadenopathy
- Bowel
- Retroperitoneal tumour
Pelvic kidney
Failure to ascend with development
What is pelvic kidney associated with?
A short ureter
What are the clinical findings for pelvic kidney? (2)
- Asymptomatic
2. Pelvic pain
What is the US appearance for pelvic kidney? (4)
- Elongated core of echogenic tissue surrounded by less echogenic parenchyma
- Located in the lower abdomen or pelvis
- Empty ipsilateral renal fossa
- Lies in an oblique plane
What are 2 differential diagnosis for pelvic kidney?
- Bowel
2. Pelvic mass
Renal ptosis
Unusual mobile kidney that descends from the normal position toward the pelvis
- poor support structures
What is the clinical finding of renal ptosis?
Asymptomatic
What is the US appearance for renal ptosis?
Abnormal mobility of a kidney
What are 2 differential diagnosis for renal ptosis?
- Pelvic kidney
2. Horseshoe kidney
What variant is a sigmoid kidney apart of?
Horseshoe kidney
What are clinical findings of sigmoid kidney? (2)
- Asymptomatic
2. Abdominal mass
What is the US appearance for a sigmoid kidney? (2)
- Superior pole of one kidney is fused with the inferior pole of the contralateral kidney
- S-shaped
What are 2 differential diagnosis for a sigmoid kidney?
- Bowel
2. Abdominal mass
Thoracic kidney
Kidney migrates into the chest through a herniation in the diaphragm
- rare finding
What is a clinical findings for thoracic kidney?
Chest mass
What is the US appearance for thoracic kidney? (3)
- Elongated core of echogenic tissue surrounded by less echogenic parenchyma
- Located in the chest
- Not easily demonstrated on
US
What is a differential diagnosis for thoracic kidney?
Chest mass
What are the dimensions for an adult kidney? (3)
- Length = 9-12cm
- Width = 4-5cm width
- Height = 2.5-3cm
What is the minimal of kidney cortical thickness?
1cm
What is the length of the kidney in a child?
7-8cm
What is the length of the kidney in an infant?
5-6cm
