Urinary System - Part 4

Question 1

Crossed fused

ectopia

Answer 1

Both kidneys are fused in the same quadrant

• 2 separate collecting systems
• 2 normally located adrenal glands

Question 2

What the the clinical findings of crossed fused ectopia? (2)

Answer 2

1. Asymptomatic

2. Abdominal mass

Question 3

What is the US appearance of crossed fused ectopia? (3)

Answer 3

1. One single, large kidney
2. Irregular contour
3. Inferior pole is directed medially

Question 4

What are 3 differential diagnosis of crossed fused ectopia?

Answer 4

1. Renal mass
2. Cake kidney
3. Sigmoid kidney

Question 5

Duplication of the kidney

Answer 5

2 distinct collecting systems

• may involve kidney, ureter, and/or renal pelvis
• may be partial or complete

Question 6

What are the clinical findings of duplication of the kidney? (2)

Answer 6

1. Asymptomatic

2. Flank pain

Question 7

What are the US appearance of duplication of the kidney? (3)

Answer 7

1. Increase in renal length
2. 2 distinct collecting systems
3. The superior system is most likely to obstruct

Question 8

What are 2 differential diagnosis of duplication of the kidney?

Answer 8

1. Hypertrophied column of Bertin

2. Renal mass

Question 9

Horseshoe kidney

Answer 9

Fusion of the kidneys usually at the inferior poles

Question 10

What is the horseshoe kidney connected by?

Answer 10

Connected by an isthmus of functioning parenchyma or non-functioning fibrotic tissue

Question 11

What is the most common form of renal fusion?

Answer 11

Horseshoe kidney

Question 12

What are the clinical findings of horseshoe kidney? (2)

Answer 12

1. Asymptomatic
2. Pulsatile abdominal
   mass

Question 13

What is the US appearance of horseshoe kidney? (4)

Answer 13

1. Bilateral low lying medially placed kidneys with partial or complete fusion of the inferior poles
2. “Dipping effect” of both inferior poles
3. Isthmus of tissue demonstrated anterior to the abdominal aorta
4. Isthmus echo texture is similar to the renal cortex

Question 14

What are 4 differential diagnosis of horseshoe kidney?

Answer 14

1. Renal mass
2. Lymphadenopathy
3. Bowel
4. Retroperitoneal tumour

Question 15

Pelvic kidney

Answer 15

Failure to ascend with development

Question 16

What is pelvic kidney associated with?

Answer 16

A short ureter

Question 17

What are the clinical findings for pelvic kidney? (2)

Answer 17

1. Asymptomatic

2. Pelvic pain

Question 18

What is the US appearance for pelvic kidney? (4)

Answer 18

1. Elongated core of echogenic tissue surrounded by less echogenic parenchyma
2. Located in the lower abdomen or pelvis
3. Empty ipsilateral renal fossa
4. Lies in an oblique plane

Question 19

What are 2 differential diagnosis for pelvic kidney?

Answer 19

1. Bowel

2. Pelvic mass

Question 20

Renal ptosis

Answer 20

Unusual mobile kidney that descends from the normal position toward the pelvis
- poor support structures

Question 21

What is the clinical finding of renal ptosis?

Answer 21

Asymptomatic

Question 22

What is the US appearance for renal ptosis?

Answer 22

Abnormal mobility of a kidney

Question 23

What are 2 differential diagnosis for renal ptosis?

Answer 23

1. Pelvic kidney

2. Horseshoe kidney

Question 24

What variant is a sigmoid kidney apart of?

Answer 24

Horseshoe kidney

Question 25

What are clinical findings of sigmoid kidney? (2)

Answer 25

1. Asymptomatic | 2. Abdominal mass

Question 26

What is the US appearance for a sigmoid kidney? (2)

Answer 26

1. Superior pole of one kidney is fused with the inferior pole of the contralateral kidney 2. S-shaped

Question 27

What are 2 differential diagnosis for a sigmoid kidney?

Answer 27

1. Bowel | 2. Abdominal mass

Question 28

Thoracic kidney

Answer 28

Kidney migrates into the chest through a herniation in the diaphragm - rare finding

Question 29

What is a clinical findings for thoracic kidney?

Answer 29

Chest mass

Question 30

What is the US appearance for thoracic kidney? (3)

Answer 30

1. Elongated core of echogenic tissue surrounded by less echogenic parenchyma 2. Located in the chest 3. Not easily demonstrated on US

Question 31

What is a differential diagnosis for thoracic kidney?

Answer 31

Chest mass

Question 32

What are the dimensions for an adult kidney? (3)

Answer 32

1. Length = 9-12cm 2. Width = 4-5cm width 3. Height = 2.5-3cm

Question 33

What is the minimal of kidney cortical thickness?

Answer 33

1cm

Question 34

What is the length of the kidney in a child?

Answer 34

7-8cm

Question 35

What is the length of the kidney in an infant?

Answer 35

5-6cm