CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSISEISENBERG

1. 36Focal or Diffuse Distortion
of Normal Renal Anatomy and
Elimination of Corticomedullary
Definition

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig GU 36-1 Focal acute bacterial nephritis. Prone
parasagittal sonogram of the left kidney (LK)
demonstrates acute focal bacterial nephritis (LN)
as focal prominence of the renal parenchyma
with poor definition of medullary pyramids in the
upper pole. (H, head.)2

4. • Fig GU 36-2 Chronic atrophic pyelonephritis. Prone
sonogram of the kidney (arrowheads) shows a focal loss of
renal parenchyma and extension of the calyces peripherally
from the renal sinus to the renal margin. Note the
associated focal area of increased echogenicity due to
fibrosis (arrow) in the upper pole.12

5. • Fig GU 36-3 Renal failure due to chronic
glomerulonephritis. Parasagittal sonogram demonstrates a
tiny right kidney (RK) with marked thinning of the renal
parenchyma. The echogenicity of the renal tissue greatly
exceeds that of the adjacent liver (L). The medullary
pyramids are no longer distinguishable. Scans of the left
kidney showed similar findings. (D, diaphragm; H, head; QL,
quadratus lumborum muscle.)2

6. • Fig GU 36-4 Renal transplant rejection. Transverse
sonogram shows that the renal transplant (RT) has become
huge and has lost its corticomedullary definition. The renal
vascular pedicle is compressed as it enters the renal hilum.
An effusion (E), sometimes seen with acute transplant
rejection, is noted medial to the kidney (R, right.).2