Image of the week
• 55yr old male presented to the OPD for getting drugs
for hypertension & routine follow up.
• Not a known DM.
• Known HT for 1yr on irregular treatment
• H/O TB when he was 35yrs old & completed ATT
• No other significant history.
• well oriented, conscious , afebrile.
• General examination was unremarkable
• Pulse : 80/min
• BP : 160/90 mm of hg
• Systems : normal
• Patient had been worked up in a private hospital in
Bangalore & few investigations were available with him.
• He presented to that hospital with abdominal pain 3 years
• KUB was ordered as he was provisionally diagnosed to
have renal calculus
• What is “putty” ?
• What does putty kidney mean?
• How to diagnose it radiographically?
• What is autonephrectomy?
Other radiological features of renal TB
• moth-eaten appearance
• phantom calix
• hiked-up or purse-string appearance
• sawtooth appearance
• pipestem ureter
• beaded or corkscrew ureter
• thimble bladder
A. Dystrophic calcification due to localised disease:
Usually one kidney or part of one kidney.
2. Hydatid disease
3. Xanthogranulomatous pyelonephritis
Aneurysm of renal artery
Contd . . .
C. Medullary :
3. Medullary Sponge Kidney
4. Renal papillary necrosis
5. Causes of hypercalcemia or hypercalciuria
6. Preterm infants
7. Primary hyperoxaluria
D. Cortical :
1. Acute cortical necrosis
2. Chronic glomerulonephritis
3. Chronic transplant rejection
• Clinical symptoms develop 10 to 15 years after
• Only about a quarter of the patient with genito
urinary involvement have known history TB
• About half of these patients have a normal chest
Symptoms of GUTB
• Increased frequency of urination
• Flank pain
• Unexplained infertility
• ASYMPTOMATIC presentation is not uncommon
• Tuberculin skin test
• CBC, ESR, CRP
• Serial early morning urine collection for AFB smear
• Serial culture LJ media
• BACTEC 460 radiometric assay