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Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Etiology/Pathophysiology:
Intrinsic narrowing of the ureteropelvic junction. The etiology of
this narrowing is due to abnormalities in longitudinal muscle
development or an aberrant crossing vessel. Twenty to thirty percent
of cases are bilateral.
Pathology:
Not applicable
Imaging Findings:
On IVP a rim of dense parenchyma around lucent dilated calyces during
the nephrogram phase (rim sign) is seen. As contrast is slowly
excreted into the collecting system it is diluted by urine retained
in the obstructed system. Later the accumulation of contrast in
collecting tubules can produce curvilinear calyceal densities
(calyceal crescents).
Ultrasound shows a dilated anechoic renal pelvis surrounded by communicating dilated calyces in the kidney.
DDX:
References:
See References Chapter.
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