Posted in General Ultrasound on May 26, 2014 by m.khodeer
10 years old female, mildly increased serum creatinine, “R/O hydronephosis”
Important findings? Dx? Cause(s)?


Related study … U/S of “neck area” Final Dx?


Answers
Medullary Nephrocalcinosis from parathyroid Adenoma


- Medullary Nephrocalcinosis: multiple areas of increases echogenicity involving all of the medullary pyramids; cortex is normal
- Typical parathyroid adenoma: hypechoic, oval, solid mass adjacent to the posterior surface of the thyroid gland
Medullary Nephrocalcinosis – CT Correction

Medullary Nephrocalcinosis: 95% of all nephrocalcinoses. Calcifications involving the distal convoluted tubules in the loops of Henle
Causes:
- Endocrine: Hyperparathyroidism, paraneoplastic syndrome, cushing’s, DI
- Alimentary: Milk-alkali, hypervitaminosis D, beryllium poisoning
- Renal: Medullary Sponge kidney, RTA, Bartter’s syndrome
- Drugs: Lasix, ACTH Rx, Vitamin E, other (e.g., sarcoid)
Tags parathyroid Adenoma, Medullary Nephrocalcinosis