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54 Cards in this Set
- Front
- Back
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Renal mass lesions
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tumor – solid, cysts; infection – lobar nephronia, abscess, XGP; congenital – duplicated collecting system; pseudotumors – fetal lobulation, dromedary hump, column of Bertin; trauma - hematoma
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Solid renal neoplasm
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RCC, oncocytoma, adenoma, AML, TCC, mets (lung, colon, melanoma, RCC), lymphoma, Wilms, mesoblastic nephroma, nephroblastomatosis, MFH
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Cystic renal masses
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tumor – cystic RCC, multilocular cystic nephroma, cystic Wilm’s, cystic mets; true cysts – cortical cysts, localized cystic disease, medullary cystic disease, ADPKD, VHL, TS, endstage renal failure, hemorrhagic or infected cyst; other – hydronephrosis/duplicated system, renal artery aneurysm, abscess
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Hyperechoic renal mass
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AML, RCC, milk of calcium cyst, nephritis (XGP, emphysematous pyelonephritis, focal nephritis, Candida), hematoma, infarction, mimics (renal sinus fat, duplicated collecting system)
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Renal sinus mass
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TCC, RCC, lymphoma, papilloma, renal artery aneurysm, renal sinus hemorrhage, complicated parapelvic cyst
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Wedge-shaped renal lesion
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renal mets, infarction, lobar nephritis
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Infiltrative
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TCC, mets, lymphoma, infarction, pyelonephritis, XGP
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Diffusely hyperechoic kidneys
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glomerulonephritis, DM, HTN, AIDS nephropathy, SLE, vasculitis, ATN, HUS, multiple myeloma, endstage renal failure, medullary or cortical nephrocalcinosis, ARPKD
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Renal calcifications
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tumors – cysts, RCC; infection – TB; metastatic calcification – medullary nephrocalcinosis, cortical nephrocalcinosis; collecting system – calculi
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Fat in kidney
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AML, lipoma, replacement lipomatosis
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Hypoechoic perirenal fat
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normal variant, perirenal hemorrhage, cyst rupture, SLE, PAN
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Filling defect in collecting system
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tumor – TCC, papilloma, leukoplakia, malakoplakia; mobile filling defect – blood clot, sloughed papillae, calculus, fungus ball; other – vascular impression, overlying bowel gas
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Papillary necrosis
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POSTCARD – pyelonephritis, obstruction, sickle cell, TB, cirrhosis, analgesics, RVT, DM
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Delayed (persistent) nephrogram
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prerenal – RAS, hypotension; renal – acute glomerulonephritis, ATN (contrast, ischemia, transplants), acute cortical necrosis (pregnancy, sepsis, dehydration), tubular precipitation (uric acid, hemolysis, myeloma), acute interstitial nephritis (antibiotics), papillary necrosis, RVT; postrenal – obstruction (stone, stricture); rule of thumb – symmetric bilateral is medical disease, asymmetric unilateral is surgical
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Striated nephrogram
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acute pyelonephritis, renal contusion, RVT, ureteral obstruction, medullary sponge kidney
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Large kidney with spindled calices
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lymphoma, leukemia, pyelonephritis, acute RA occlusion, acute RVT, acute obstruction
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Normal size kidney with spindled calices
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multiple cysts (parapelvic or peripelvic), renal sinus lipomatosis
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Hypodense rim
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acute cortical necrosis, perinephric lymphoma
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Subcapsular rim sign
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infarct, ATN, RVT
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Extracalyceal contrast
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striations – medullary sponge kidney, early papillary necrosis, pyelosinus or pyelovenous backflow in obstruction, interstitial edema; focal collections – late papillary necrosis, calyceal diverticulum, cavity from cyst rupture, abscess
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Dilated calyces/collecting system
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obstruction, papillary necrosis, congenital megacalyces, calyceal diverticulum, reflux
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Bilaterally enlarged kidneys
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ADPKD, lymphoma, glomerulonephritis, HIV, amyloid, bilateral RVT
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Bilaterally small kidneys
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chronic inflammation, bilateral RAS, chronic reflux, ESRD
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Unilateral renal atrophy (smooth)
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chronic ischemia (RAS, RVT), postobstructive atrophy, renal hypoplasia, chronic subcapsular hematoma, radiation
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Unilateral renal atrophy (irregular)
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reflux nephropathy, analgesic nephropathy, DM
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Renal TB
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parenchymal calcs, putty kidney, papillary necrosis, tuberculoma, scarring, mucosal irregularity, infundibular stenosis, amputated calyx, corkscrew ureter, purse-string stenosis of renal pelvis, pipestem ureter, calculi, small contracted thick-walled bladder, urethral fistulas (watering can perineum)
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Hypercalcemia
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parathyroid adenoma or hyperplasia, Addison disease, milk alkali, sarcoid, carcinomatosis, HPT, myeloma, immobilization, vitD, thiazides
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Cortical nephrocalcinosis
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chronic glomerulonephritis, cortical necrosis (pregnancy, shock, sepsis, toxins), AIDS nephropathy, Alport’s, oxalosis, chronic transplant rejection
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Medullary nephrocalcinosis
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HPT, RTA, medullary sponge kidney, papillary necrosis, Lasix therapy in kids
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Renal vein thrombosis
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tumor - RCC, Wilm’s, lymphoma, TCC, adrenal, gonadal, pancreatic CA, extraluminal compression by retroperitoneal tumor; renal disease – membranous glomerulonephritis, SLE, amyloid; other – hypercoagulable state, extension of ovarian vein or IVC thrombosis, trauma, surgery, transplant complication, dehydration in kids
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Dilated ureter
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criteria - >8mm, ureter visible in entire length, no peristaltic waves; obstruction – primary megaureter (functional), ureteral stricture, calculus, BOO, urethral stricture; reflux; diuresis
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Ureteral stricture
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tumor – TCC, mets, lymphadenopathy; inflammatory – TB (corkscrew appearance), Schistosomiasis, Crohn’s, PID; congenital – ectopic ureterocele, primary megaureter, congenital stenosis; metabolic, drugs – amyloid, morphine, methysergide (retroperitoneal fibrosis); trauma – iatrogenic, radiation; vascular – aneurysm, ovarian vein syndrome, lymphocele, crossing vessel
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Multiple ureteral filling defects
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wall – ureteritis cystica (more common in upper ureter), vascular impressions, multiple papillomas, melanoma mets, submucosal hemorrhage, fibroepithelial polyp (single); luminal (acute angles) – calculi, blood clot, sloughed papillae, fungus ball, air bubbles, TCC
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Ureteral diverticula
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congenital, pseudodiverticulosis, TB (also strictures)
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Deviated ureters
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lateral – bulky RP adenopathy, primary RP tumors, RP fluid collection, aneurysm, malrotated kidney, ovarian or uterine mass; medial – posterior bladder diverticulum (#1 cause of distal medial deviation), fibroids, RP fibrosis, postoperative, enlarged prostate, retrocaval ureter (only on R side)
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Bladder wall thickening
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criteria - >5mm, trabeculations; tumor – TCC, lymphoma; inflammation – radiation, cytoxan, infection, IBD, appendicitis, diverticulitis; BOO – BPH, PUV, ectopic ureterocele, urethral stricture; neurogenic
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Bladder filling defect
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tumor – TCC, SCC, mets, leiomyoma, endometriosis, polyps; infection – PID, Schistosomiasis, fungus ball, leukoplakia, malacoplakia, cystitis cystica, cystitis glandularis; luminal – calculi, blood clot, BPH, foreign body, ureterocele, pseudoureterocele; adjacent inflammatory process e.g. appendicitis or divertiticulitis; rare – amyloid
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Bladder neoplasm
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TCC, SCC, adenocarcinoma, leiomyoma, pheochromocytoma, mets (melanoma, prostate), lymphoma, urachal adenoCA (dome); risk factors
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Bladder wall calcification
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SCRITT – Schistosomiasis, cytoxan, radiation, interstitial cystitis, TB, TCC
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Air in bladder
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instrumentation, catheter, bladder fistula (diverticulitis, Crohn’s, colon CA), emphysematous cystitis (DM)
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Teardrop bladder
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normal variant, iliopsoas hypertrophy, hematoma, abscess, lymphoma, pelvic lipomatosis, RP fibrosis, IVC obstruction
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Bladder fistulas
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diverticulitis, Crohn’s, CA, surgery, radiation
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Bladder diverticula
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congenital (Hutch, urachal), acquired (BOO)
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Bladder rupture
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trauma, radiation, tumor, cystitis, neurogenic bladder
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“Female prostate”
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central filling defect at base of bladder; urethral diverticulum, urethral tumor, periurethritis, pubic bone lesion
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Urethral stricture
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GC, trauma, iatrogenic
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Adrenal masses
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tumor - adenoma, mets (esp small cell), pheochromocytoma, lymphoma, neuroblastoma, carcinoma, hemangioma; fatty – adenoma, myelolipoma, lipoma; cystic – simple cyst, pseudocyst from hemorrhage; other – hemorrhage, TB, Wolman’s disease; bilateral – hemorrhage, mets, lymphoma, bilateral pheochromocytoma (MEN2, VHL, NF), TB, histo, adenomas, hyperplasia
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Adrenal calcifications
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tumor – neuroblastoma, pheochromocytoma, carcinoma, myelolipoma, hemangioma; infection – TB, histo, meningococcemia; trauma – hemorrhage; congenital – Wolman’s, Addison’s; cyst
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Adrenal pseudotumors
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gastric fundus, varices, tortuous splenic artery, pancreatic tail, medial splenic lobulation
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Large retroperitoneal mass
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hematoma, abscess, adenopathy from lymphoma or mets, liposarcoma, leiomyosarcoma, MFH, neurogenic tumor, germ cell tumor
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Retroperitoneal hematoma
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anticoagulation, trauma, iatrogenic, ruptured AAA, RCC, AML
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Retroperitoneal air
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trauma (perforation), ERCP, emphysematous pyelonephritis
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Retroperitoneal abscess
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pancreatitis, renal inflammatory disease, osteomyelitis
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Retroperitoneal fibrosis
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idiopathic, methysergide, radiation, surgery, lymphoma, mets, retroperitoneal fluid, inflammation from other organs
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