URINARY TRACT DISORDERS URINARY TRACT DISORDERS Urinary tract Calculi : Urinary tract Calculi : -Calcified to varying degree -Calcified to varying degree uniform uniform laminated laminated -Radiolucent ( Xanthine and Uric acid) -Radiolucent ( Xanthine and Uric acid) - all stones are seen on CT and US - all stones are seen on CT and US
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tubular acidosis and hyperparathyroidism tubular acidosis and hyperparathyroidism Normal calcium metabolism: Medullar Normal calcium metabolism: Medullar
sponge kidney or widespread papillary sponge kidney or widespread papillary necrosis necrosis
Dilatation of PCS and ureter.Dilatation of PCS and ureter.
Degree Degree
Level Level
US in Urinary Tract Obstruction US in Urinary Tract Obstruction Fluid collection in middle of central sinus Fluid collection in middle of central sinus
Should be differentiated from cysts Should be differentiated from cysts
Cortex ?Cortex ?
Ureter ( proximal and distal parts seen)Ureter ( proximal and distal parts seen)
Cause ? Stone, bladder mass, pelvic massCause ? Stone, bladder mass, pelvic mass
IVU in obstruction IVU in obstruction
In some centers remains the primary In some centers remains the primary imaging modality of acute ureteric colic .imaging modality of acute ureteric colic .
Plain film : calculus Plain film : calculus
After 15 min of contrast injection : After 15 min of contrast injection :
if urogram normal it rules out uretric if urogram normal it rules out uretric colic as the cause of the pain colic as the cause of the pain
If obstructed : If obstructed :
dense nephrogram dense nephrogram
delayed filmsdelayed films
obstruction can be intermittent obstruction can be intermittent
CT in urinary tract obstrcution CT in urinary tract obstrcution
Peristalsis not transmitted Peristalsis not transmitted Age : usually in children and young adultsAge : usually in children and young adultsDiagnoses ? Dilated pelvis , normal ureterDiagnoses ? Dilated pelvis , normal ureter
Should be differentiated from baggy pelvis Should be differentiated from baggy pelvis
by giving diuretic during IVU by giving diuretic during IVU
Extrinsic causes of obstruction Extrinsic causes of obstruction
Best evaluated by CT : Tumors Best evaluated by CT : Tumors
Retroperitoneal fibrosis; usually at the Retroperitoneal fibrosis; usually at the level of L4/5 level of L4/5