Wk 3, Case 2 - Review

EXAM: Renal Ultrasound (US)

INDICATION: 62-day-old girl with hydronephrosis.

TECHNIQUE: Ultrasound imaging of the kidneys and urinary bladder was obtained using two-dimensional grayscale imaging. Color Doppler images were obtained to evaluate vascular flow.

FINDINGS:

Right Kidney:

Length: 5.2 cm

Prior length: 5.5 cm

Parenchyma: Diffusely thin with tiny dysplastic cysts

Pelvic dilatation: Severe with extrarenal pelvis, APD measures 2.2 cm, previous APD 2.4 cm

Calyceal dilatation: Severe

Hydronephrosis grade: 4

Interval hydronephrosis change: None

Left Kidney:

Length: 4.8 cm

Prior length: 4.6 cm

Parenchyma: Normal

Pelvic dilatation: None, APD N/A, previous APD N/A

Calyceal dilatation: Major calyces: None, Minor calyces: None

Hydronephrosis grade: 0

Interval hydronephrosis change: None

The ureters are not seen. There is adequate distention of the bladder (9 mL), which appears normal. Incidental note is made of a prominent right ovary measuring up to 1.7 x 1.6 x 2 cm with multiple follicles (less than 1 cm), as is not uncommon in this age.

IMPRESSIONS:

1. Right grade 4 hydronephrosis with tiny dysplastic parenchyma cysts and large extrarenal pelvis, suggestive of long-standing UPJ obstruction.
2. Normal appearance of the left kidney and bladder.