*A 44-year-old man presented with renal colic and chronic kidney disease.
What is the most likely diagnosis?
1. Nephrolithiasis
2. Medullary Nephrocalcinosis and Nephrolithiasis
3. Cortical Nephrocalcinosis and Nephrolithiasis
4. Renal Cortical Necrosis and Nephrolithiasis
Answer
Case Discussion:
Unenhanced – coronal reformatted CT scan of abdomen in a 44-year-old man with renal colic and chronic kidney disease shows bilateral punctate calcifications in the region of the medullary consistent with medullary nephrocalcinosis and right nephrolithiasis. There was hyperparathyroidism in the patient.
Causes includes:
• Medulla (most common)
o hyperuricemia
o infection
o sickle cell disease
o renal papillary necrosis
• cortical nephrocalcinosis
References:
1.Eisenberg RL, Margulis AR. The Right Imaging Study, A Guide for Physicians. Springer Verlag. (2008) ISBN:0387737731. Read it at Google Books – Find it at Amazon
2.Dähnert W. Radiology Review Manual. Lippincott Williams & Wilkins. (2007) ISBN:0781766206. Read it at Google Books – Find it at Amazon