Angiomyolipomas
I got an econsult this morning on a young patient with an incidentally-discovered lesion on her kidney which was consistent with an angiomyolipoma. It is not uncommon to see these on ultrasound and there are a few clinical…
Emphysematous Pyelonephritis
I was asked to see 74 year old man with an acute on chronic kidney injury. He had 2 days of generalised lower abdominal pain and vomiting but no urinary symptoms or fever. His past history included advanced…
The evolving role of PET imaging in Nephrology
Positron emission tomography (PET) is a nuclear imaging modality that provides functional imaging of structures based on their ability to metabolize glucose and concentrate specific molecules that have been labeled with a positron-emitting radionuclide. Metabolically active cells (e.g,…
Ultrasound Course for Nephrologists
Continuing our practice of highlighting excellent courses for Nephrologists and Fellows, here is a message from Professor W. Charles O’Neill regarding the annual Ultrasound for Nephrologists Course at Emory University this October. The course brochure and application form…
Less is More
Despite the fact that the kidney ultrasound is generally obtained as one of multiple recommendations when evaluating AKI, the benefit of kidney ultrasound is not clear. The post-renal causes of AKI are not very common. It adds to…
Diagnosis and Management of Post-Transplant Fluid Collections
We were evaluating a kidney transplant recipient three weeks after surgery who presented with a rise in creatinine. We obtained an ultrasound which showed a large fluid collection and mild hydronephrosis. Prograf level was at goal. Peritransplant fluid…
Evaluating incidental renal cysts
Last week, I got an email from a residency friend asking me what I would do with a patient who had a Bosniak II renal cyst. Since “I don’t know” no longer seemed a satisfactory answer for someone…
Caveats for Using Renal Ultrasound to Diagnose Post-Renal Failure
Most would agree that the renal ultrasound is an invaluable tool in the workup of acute kidney injury. Although the renal ultrasound can give information regarding kidney echogenicity and presence of renal cysts, by and large its predominant…
Differential Diagnosis for Large Kidneys
The differential diagnosis for large kidneys (often demonstrated on renal ultrasound) is interesting, as there are a few conditions which are especially associated with this finding. Of course, with any type of chronic damage, the kidneys tend to…
Urinoma
Time for some “Renal Radiology Rounds.” The case involves a 77 year-old man with a history of severe benign prostatic hypertrophy. He had been advised to have a TURP in the past but had repeatedly declined. He was…