Nephrocalcinosis differential diagnosis

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  3. gly a simple finding, incorporates numerous potential disease processes in the differential. An effort should be made to describe the..
  4. The differential diagnoses besicles those of nephrocalcinosis are renal tuberculosis, calyceal diverticulum and cysts, papillary necrosis and so-called tubular stasis. Amongst these, renal tuberculosis is most important as it is often wrongly misdiagnosed in cases of medullary sponge kidney and unnecessary prolonged chemotherapy instituted
  5. ed and a causative therapy initiated
  6. 1. Dtsch Gesundheitsw. 1965 Jun 3;20(22):989-92. [On the differential diagnosis of nephrocalcinosis]. [Article in German] Buchali K, Strangfeld D, Schröter R
  7. Renal medullary nephrocalcinosis is the commonest form of nephrocalcinosis and refers to the deposition of calcium salts in the medulla of the kidney. Due to the concentrating effects of the loops of Henle, and the biochemical milieu of the medulla, compared to the cortex, it is 20 times more common than cortical nephrocalcinosis.. Often (and perhaps unsurprisingly) the same entities may also.

Differential Diagnosis. Cortical nephrocalcinosis is typically the result of dystrophic calcification, which occurs subsequent to parenchymal tissue destruction rather than the precipitation of excessive urinary constituents. The causes include infarction, malignancy, and infection. Prognosi 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. Schepens D, Verswijvel G, Kuypers D et-al. Images in Nephrology. Renal cortical nephrocalcinosis

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Nephrocalcinosis is caused by multiple different conditions, and the kidney prognosis is determined by the underlying cause; whereas most patients with nephrocalcinosis do not progress to end-stage kidney disease, certain underlying conditions, if not effectively treated, may be associated with progressive kidney dysfunction Renal sinus mass effect. Clubbing or destruction of renal calyces. Extra-calyceal contrast. Lateral proximal ureteral deviation. Medial deviation of proximal or mid ureter. Medial displacement distal ureters. Intraluminal filling defects renal pelvis/calyces/ureters. Ureteral filling defects. Obstruction of the ureter Am Fam Physician. 2003 May 1;67 (9):1959-1966. Hypercalcemia is a disorder commonly encountered by primary care physicians. The diagnosis often is made incidentally in asymptomatic patients.

Nephrocalcinosis, the deposition of calcium phosphate crystals within renal tubules and sometimes within interstitium, may occur at any age. Patients may present with acute kidney injury (AKI) Nephrocalcinosis is defined as the deposition of calcium phosphate in renal tissue, although a variety of additional terms are sometimes employed to reflect the localization of the mineral in the cortex, medulla, and so on. From: Laboratory Animal Medicine (Second Edition), 200

The physical examination should be directed toward excluding differential diagnoses (e.g., urinary tract infection, (for nephrocalcinosis and other metabolic abnormalities),. Nephrocalcinosis is a condition in which calcium levels in the kidneys are increased. Most often, the increase in renal calcium is generalized, as opposed to the localized increase observed in.. Differential Diagnosis Cortical nephrocalcinosis Final Diagnosis Cortical nephrocalcinosis due to renal tubular acidosis Discussion Calcification within the renal parenchyma is known as nephrocalcinosis. This can be either cortical or medullary in location Lidvana Spahiu et al., Aetiology, Diagnosis and Clinical Characteristics of Nephrocalcinosis www.jcdr.net Journal of Clinical and Diagnostic Research. 2018 Mar, V ol-12(3): SC09-SC12 12 1 Nephrocalcinosis is defined by calcium phosphate or calcium oxalate deposits in the kidney parenchyma, particularly in tubular epithelial cells and interstitial tissue. It should be differentiated from urolithiasis where calcium salts deposits are located in the kidney and urinary tract. The epidemi

Nephrocalcinosis Differential Diagnoses - Medscap

  1. Daga A, Majmundar AJ, Braun DA, Gee HY, Lawson JA, et al. Whole exome sequencing frequently detects a monogenic cause in early onset nephrolithiasis and nephrocalcinosis. Kidney Int . 2017 Sep 8.
  2. 1. Singapore Med J. 1967 Sep;8(3):139-42. Medullary sponge kidney in the radiological differential diagnosis of nephrocalcinosis. Yu SF. PMID
  3. Differential Diagnosis Medullary nephrocalcinosis [which has many causes including medullary sponge kidney, renal tubular acidosis, sarcoidosis, metastatic disease, hyperparathyroidism and milk alkali syndrome]
  4. Differential Diagnosis During the early ischemic stage of renal papillary necrosis, corticomedullary or parenchymal phase multi-detector row CT shows a poorly marginated area of decreased enhancement at the tip of the medullary pyramid
  5. imumurine pH of less than 5.5. Thus, us-ing the

Nephrocalcinosis is a condition in which calcium levels in the kidneys are increased. There is predominantly interstitial deposit of calcium phosphate or calcium oxalate in the renal cortex and/or medulla. This opposing effect of hypercalcemia and parathyroid hormone has been used in the differential diagnosis of hypercalcemia, because. nephrocalcinosis. Differential Diagnosis Calcium phosphate crystals are bluish-purple and nonpolarizable. Other crystals, such as cal-cium oxalate or 2,8-dehydroxyadenine, polarize. Of note, nonspecific occasional calcium phosphate crystals may be seen secondary to any CKD and are not specifically indicative of an underlyin

[Pathophysiology and diagnosis of nephrocalcinosis

  1. ant hypocalcemia, Dent disease, hereditary hypophosphatemic rickets with hypercalciuria, distal renal tubular acidosis and other tubular disorders causing early nephrocalcinosis (like primary hyperoxaluria) (see these terms)
  2. Differential diagnosis is mandatory: with papillary necrosis of the kidney, tuberculosis of the kidney, pneumocystis or mycobacterial extrapulmonary infection in patients with AIDS, etc. Nephrocalcinosis should not be confused with nephrolithiasis, that is, the formation of kidney stones, although in some patients both pathologies are present.
  3. Nephrocalcinosis (NC) is a condition in which there is deposition of calcium in the renal parenchyma and tubules. NC refers to the deposition of both calcium phosphate and calcium oxalate crystals, but the most important criterion is the generalized deposition of calcium in the kidney
  4. Nephrocalcinosis. Etiology: chronic lasix usage in neonate with respiratory distress syndrome. Imaging: medullary calcification occurs in collecting tubules near papillae, calcification can be excreted into calyces + cause obstruction

[On the differential diagnosis of nephrocalcinosis]

  1. The differential diagnoses are based on the mechanisms leading to hypophosphataemia — namely, high PTH activity, inadequate phosphate absorption from the gut or renal phosphate wasting
  2. The differential diagnosis for this finding includes inflammation (especially tuberculosis and occasionally acute pyelonephritis), neoplasm (especially transitional cell carcinoma), a stricture from trauma or stone passage, ischemia, a congenital anomaly of the calix, renal contusion, or technical underfilling (, Fig 32) (, 35)
  3. pattern is an early manifestation of nephrocalcinosis [10]. This could be useful information to sonographers involved in the diagnosis of nephropathy. CT is the most accurate and sensitive technique and therefore the modality of choice [2]. In conclusion, we considered that furosemide treatment should be part of differential diagnosis
  4. al radiographs as thin peripheral lines of calcification (tram lines), diffusely dense renal shadows, or as diffuse punctate calcifications representing necrotic cortical tubules ()
  5. However, some degree of renal tubular acidosis may be acquired during long-standing XLH, particularly when associated with nephrocalcinosis . The differential-diagnosis of Fanconi syndrome itself is broad and includes (non-exhaustively) mitochondrial respiratory chain diseases, metal intoxications, Wilson's disease, cystinosis, multiple.
  6. Our differential diagnosis included disorders resulting in nephrocalcinosis. This term is used to describe the deposition of calcium in the renal parenchyma and tubules. It is caused by an increase in the urinary excretion of calcium, phosphate and/or oxalate. Hypocitraturia also may contribute

Medullary nephrocalcinosis Radiology Reference Article

Medullary sponge kidney | Radiology Case | Radiopaedia

Dent disease is an X-linked recessive disorder of the proximal tubules that is characterized by low-molecular-weight proteinuria, hypercalciuria, nephrocalcinosis, kidney stones, kidney failure, and rickets [ 1,2 ]. (See 'Molecular genetics' below.) The following topic review will present the genetics, clinical manifestations, and treatment of. The commonest causes are primary hyper-parathyroidism and renal tubular acidosis, although any disorder leading to hypercalcemia may be implicated and a list of these is given in Table 3.1. 16 Frusemide therapy is recognized as a cause of nephrocalcinosis in infants and recent reports suggest that nephrocalcinosis may also be seen in adults who. In some cases where Medullary Nephrocalcinosis is caused by renal tubular acidosis the damage done to the kidneys is basically irreversible. Thus, it is highly recommended that an individual needs to start immediate treatment once a cause is identified and the diagnosis is confirmed of Medullary Nephrocalcinosis. Also Read Search for: Rare Disease Profiles; 5 Facts; Rare IQ; Rare Mystery;

Nephrocalcinosis Article - StatPearl

  1. For differential diagnosis some other disorders should be excluded: disorders of intestinal magnesium absorption and magnesium-loosing renal diseases: 1. Activating mutations in Ca-Mg receptor with hypercalciuria, nephrocalcinosis and hypoparathyreosis, 2. Salt loosing tubular disorders - Bartter syndrome (I, II, III, IV) and Gitelman.
  2. Nephrocalcinosis is the first and most common differential diagnosis to urolithiasis in newborns. In our case, nephrocalcinosis was ruled out by the lack of echogenicity of medullary region, echogenic focus in upper pole with acoustic shadow and mild right hydronephrosis. On subsequent follow-up, the infant was not found to have any crystals on.
  3. Research has demonstrated that medullary nephrocalcinosis is not as easily diagnosed as cortical nephrocalcinosis because there are several differential diagnoses for echogenic renal pyramids, whereas increased echogenicity of the renal cortex is usually cortical nephrocalcinosis. 5 The primary difference between MSK and medullary.
  4. osis D, and primary hyperparathyroidism are the most common diagnoses. Nephrocalcinosis and urolithiasis may develop.
  5. Laboratory workup for the differential diagnosis of nephrocalcinosis was done: complete urinalysis, including urinary calcium excretion, urine pH and electrolytes, arterial blood gas (ABG), serum.
  6. Diagnosis Patient was diagnosed with bilateral nephrocalcinosis or parenchymal calcification. This occurs when calcium deposits in renal tissue. It is most commonly found within the medulla and affects both kidneys. Generally there are no early symptoms. Differential Dx Medullary sponge kidney and nephrolithiasis
  7. The diagnosis of medullary nephrocalcinosis was made by ultrasounds and confirmed at CT scan after delivery ( Figures 3 and 4). The clinical history suggests that nephrocalcinosis preceded the first pregnancy: the rhabdomyolysis points to a urinary concentration deficit, contributing to dehydration, and upper urinary tract infections are known.

Cortical nephrocalcinosis Radiology Reference Article

The diagnosis of distal renal tubular acidosis was made, based on hypokalemic hyperchloremic metabolic acidosis with a normal anion gap, high urine pH, hypercalciuria, medullary nephrocalcinosis and exclusion of other differential diagnosis The medullary nephrocalcinosis pattern of type 1 primary hyperoxaluria must be included in the differential diagnosis of hypercalciuric nephrocalcinosis. Diseases with a specific association of hypercalciuria and nephrocalcinosis are numerous, and the differential diagnosis cannot be based on the sonographic pattern alone [10-14]

Nephrocalcinosis - UpToDat

Calcification and the Kidneys. Calcification is the abnormal accumulation of calcium salts in body tissue. This abnormal accumulation of calcium in the kidney is referred to as nephrocalcinosis. Medullary sponge kidney (MSK) is a rare disease characterized by cystic dilatation of papillary collecting ducts. Intravenous urography is still considered the gold standard for diagnosis. We identified a cohort of patients from our outpatient clinic with established diagnosis of MSK to outline some ultrasonographic characteristics that may help establish a diagnosis

GU Imaging Differential Diagnoses - LearningRadiolog

V-shaped reverberation artifacts emanate from anterior wall. Due to small cholesterol crystals lodged within Rokitansky-Aschoff sinuses of thickened gallbladder wall. References: https://bit.ly/3tCjnBe. Return Back. Correct Answer Explanation The grade of nephrocalcinosis increased from 0.4 /- 0.2 to 1.5 /- 0.3 in the 2.3 /- 0.3 years before initiation of HCTZ therapy, whereas the degree of nephrocalcinosis was [ncbi.nlm.nih.gov] Review Topic QID: 3143 1 Primary hyperparathyroidism 2 Type I vitamin D deficient rickets 3 Type II vitamin D deficient rickets 4 X-linked hypophosphatemic.

resorption of phosphate was normal (> 80%). The diagnosis of distal renal tubular acidosis was made, based on hypokalemic hyperchloremic metabolic acidosis with a normal anion gap, high urine pH, hypercalciuria, medullary nephrocalcinosis and exclusion of other differential diagnosis. The child showed symptomati Dent's disease is a renal tubular disorder characterized by manifestations of proximal tubule dysfunction, including low-molecular-weight proteinuria, hypercalciuria, nephrolithiasis, nephrocalcinosis, and progressive renal failure. These features are generally found in males only, and may be present in early childhood, whereas female carriers may show a milder phenotype. Prevalence is unknown.

FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6963 interlinked topic pages divided into a tree of 31 specialty books and 737 chapters Conditions associated with nephrocalcinosis and nephrolithiasis are described. Some (cystinuria, urate) have specific therapies, and there are some general measure, particular for calcium-containing stones (urine volume, dietary salt, urinary citrate, thiazide diuretics). In the absence of a primary aetiology, urinary biochemical predisposing factors can be manipulated Diagnosis: Patient was diagnosed with bilateral nephrocalcinosis or parenchymal calcification. This occurs when calcium deposits in renal tissue. It is most commonly found within the medulla and affects both kidneys. Differential Dx: Medullary sponge kidney and nephrolithiasis Diagnosis is confirmed by genetic screening of CLDN16 and CLDN19. Differential diagnosis Differential diagnosis includes Bartter syndrome, autosomal dominant hypocalcemia, Dent disease, hereditary hypophosphatemic rickets with hypercalciuria, distal renal tubular acidosis and other tubular disorders causing early nephrocalcinosis (like primary.

A Practical Approach to Hypercalcemia - American Family

Differential diagnosis of Nephrocalcinosis. Conditions with hypercalcemia and hypercalciuria. Conditions with hypercalciuria in the absence of hypercalcemia • Primary hyperparathyroidism • Vitamin D therapy • Milk alkali syndrome • Congenital hypothyroidism • Sarcoidosis The differential diagnosis of nephrocalcinosis is broad. Systemic diseases such as hyperparathyroidism, vitamin D intoxication and sarcoidosis should ®rst be excluded. The remainder may be associated with tubular disorders. Distal renal tubular acidosis, idiopathic hypercalciuria, hypomagnesaemic hypercalciuric nephrolithiasis, Bartter's.

AJKD Atlas of Renal Pathology: Nephrocalcinosis and Acute

Comment: The differential diagnosis for these findings includes both secondary and primary causes. Secondary hyperoxaluria / oxalate nephropathy can be seen in the setting of gastrointestinal malabsorption (enteric hyperoxaluria) or exogenous / dietary oxalate ingestion (e.g. excess vitamin C, rhubarb, parsley, spinach, beet greens, star fruit. Amelogenesis imperfecta is a heritable dental disease that affects 1 in 14,000 in the U.S. Children with amelogenesis imperfecta do not produce functional proteins that are required to create and lay down effective enamel.As a result, their teeth can be discolored, misshapen, or fragile, and most cases require dental work to preserve or replace teeth Asymptomatic hypercalcemia (total serum calcium corrected by albumin), without guiding signs or symptoms, is the most frequent manifestation of the disease. For the differential diagnosis, PTH(1-84) must be measured, as well as phosphate, chloride, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and calcium-to-creatinine clearance Early diagnosis aids in retardation of the progression to kidney failure. We present two unrelated patients presenting with nephrocalcinosis and deranged renal function, who had a novel pathogenic variation (c.685C > T; p.Q229X), leading to the diagnosis of FHHNC

Nephrocalcinosis - an overview ScienceDirect Topic

Medullary Nephrocalcinosis

Kidney Stones: Treatment and Prevention - American Family

In conclusion, we considered that furosemide treatment should be part of differential diagnosis list of medullary nephrocalcinosis in adults undergoing long-term therapy with this drug, especially if the high dose of drug is used as in this case. References. Alon US. Nephrocalcinosis. Curr Opin Pediatr. 1997; 9: 160-165 Medullary Sponge Kidney is a rare disorder that affects slightly more women than men. It is thought to occur in 1 in 1,000 to 5,000 people in the United States. Although the symptoms of Medullary Sponge Kidney may begin at any age, they usually develop during adolescence or in adults between the ages of 30 and 50 years

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Sonographische Befunde und Differentialdiagnostik Nephrocalcinosis in childhood - sonographic findings and differential diagnosis C. Gückel 1, G. Benz-Bohm 1, B. Roth 2 1 Radiologisches Institut (Direktor: Prof. Dr. G. Friedmann) un The differential diagnoses listed here are not exhaustive. Treatment Approach considerations [13] Determine if it is a complicated case, including: high-grade or infected hydronephrosis, urosepsis, acute kidney injury, intractable pain, or vomiting; Treatment depends on the size of the stone Nephrocalcinosis is a key feature in the diagnosis of MSK. Patients can present with haematuria, renal colic, dysuria and passage of small stones. Several mechanisms have been proposed for the pathogenesis of stone formation. Firstly, the stagnation of urine in the collecting tubules favours precipitation of stone material Differential Diagnosis of Sarcoidosis Sarcoidosis is an inflammatory disorder resulting in noncaseating granulomas in one or more organs and tissues; etiology is unknown. The lungs and lymphatic system are most often affected, but sarcoidosis may affect any organ be helpful in the differential diagnosis to identify patients with MSK. Keywords: Renal cystic disease, Ultrasonography, Medullary sponge kidney, Nephrolithiasis, Chronic renal failure 39% because of a previous diagnosis of MSK, nephrocalcinosis or because of recurrent episodes of nephrolithiasis. Overall, there were 5 patients (28%

Williams syndrome should be kept as a differential diagnosis in children presenting with facial dysmorphic features with cardiovascular and altered calcium metabolism. Early identification of hypercalcaemia in these patients may avoid risk of severe manifestations like nephrocalcinosis Adverse renal outcome, seen in a significant proportion of patients during long-term follow-up, is attributed chiefly to chronic hypovolemia and nephrocalcinosis., With early diagnosis and careful attention to fluid and electrolyte supplementation, outcomes have improved, and majority of cases survive beyond infancy (Cases 11, V, and VI). In Case 11, gross In the differential diagnosis of the evidence of calcifications was found in the nephrocalcinosis associated with sarcoid, calices and in the medullary pyramids. two other important diseases must be conMicroscopically the calcifications were sidered Background. Defined as either urinary calcium excretion greater than 4 mg/kg (0.1 mmol/kg) per day OR greater than 250 mg/day (6.24 mmol/day) in women and greater than 300 mg/day (7.49 mmol/day) in men

Nephrocalcinosis: Practice Essentials, Background

In this report, we describe a case of crystalglobulin-induced nephropathy and discuss its pathophysiology and the differential diagnosis of paraprotein-induced crystalline nephropathy. AB - Crystalline nephropathy refers to renal parenchymal deposition of crystals leading to kidney damage 10% of patients; another 10% develop nephrocalcinosis. DIFFERENTIAL DIAGNOSIS OF PULMONARY SARCOIDOSIS Sarcoidosis Beryllium exposure Hypersensitivity pneumonitis Idiopathic pulmonary fibrosis Mycobacterial infection Fungal infections Methotrexate-induced pneumonitis Wegener's granulomatosis FIGURE 8-5 Differential diagnosis of pulmonary. Benign intracranial hypertension (BIH) is a headache syndrome characterised by (1) raised cerebrospinal fluid (CSF) pressure in the absence of an intracranial mass lesion or ventricular dilatation; (2) normal spinal fluid composition; (3) usually normal findings on neurological examination except for papilloedema and an occasional VI nerve palsy; and (4) normal level of consciousness. The.

SONOWORLD : Cortical nephrocalcinosi

Differential diagnoses of hyperuricosuria and hyperuricemia with nephrocalcinosis included neoplasic disorders and inborn errors of metabolism of purines, such as Lesch-Nyhan syndrome. HPRT activity in erythrocyte lysates was determined by means of a high-performance liquid chromatography method. 12 The low detection limit was 0.01 nmol/ h/mg. In this case, the renal ultrasound demonstrating nephrocalcinosis was particularly pivotal in the diagnosis due to the equivocal urine calcium measurement. Given the lengthy differential diagnosis for phosphate wasting, genetic analysis is generally considered necessary for a conclusive diagnosis of HHRH. 4. Conclusion Differential diagnosis of Evaluation of magnesium deficiency: Malnutrition, Isolated dietary magnesium deficiency, Drug-induced, Alcohol abuse, Laxative abuse

In Bartter syndrome, the defect is in the ascending thick limb of the loop of Henle. In Gitelman syndrome, the defect is in the distal tubule. In both syndromes, the impairment of sodium chloride reabsorption causes mild volume depletion, which leads to increases in renin and aldosterone release, resulting in potassium and hydrogen losses Introduction. Medullary sponge kidney (MSK) disease is a rare condition affecting the distal nephron within the renal medulla and typically presents itself with nephrocalcinosis, distal renal tubular acidosis, and hypocitraturia. 1-3 MSK is defined as dilatation of medullary and papillary portions of the collecting ducts due to cystic damage to the distal nephron. 4 MSK acquires its name. A diagnosis of nephrolithiasis may be suspected based on the clinical history, physical exam findings, and laboratory test results, and is confirmed with imaging studies. Clinical history Obstructed renal and ureteric stones can cause renal colic: severe, acute flank pain that may radiate to the ipsilateral groin, commonly associated with. Aug 14, 2013 - An award-winning, radiologic teaching site for medical students and those starting out in radiology focusing on chest, GI, cardiac and musculoskeletal diseases containing hundreds of lectures, quizzes, hand-out notes, interactive material, most commons lists and pictorial differential diagnose Oct 30, 2016 - This Pin was discovered by Stelios Daskalogiannis. Discover (and save!) your own Pins on Pinteres

(PDF) Aetiology, Diagnosis and Clinical Characteristics of

Nephrocalcinosis and/or biomarker levels of the disorder should raise suspicion and encourage the inclusion of HPP as a differential diagnosis. Biomarkers are a major contributor to diagnosis [6,16,18,23,24]. However, for definitive diagnosis, ALPL gene testing should be done . Two studies attempted to prepare diagnostic guidelines, but. Renal Tubular Acidosis Differential Diagnosis. A number of health conditions resemble the signs and symptoms commonly shown by RTA. It is, thus, necessary for a doctor to differentiate RTA from these similar conditions while determining the clinical diagnosis so that appropriate treatment measures can be undertaken

[Nephrocalcinosis in children

The differential diagnosis of crystals in the retina. Int Ophthalmol. 2001;24(3):113-121. ↑ 2.0 2.1 Derveaux T, Delbeke P, Walraedt S, et al. Detailed clinical phenotyping of oxalate maculopathy in primary hyperoxaluria type 1 and review of the literature. Retina. 2016;36(11):2227-2235 Nephrocalcinosis in infancy has been generally associated with prematurity, furosemide use, conditions associated with hypercalcemia, distal renal tubular acidosis (dRTA), Bartter syndrome, Dent's disease, primary hyperoxaluria, hereditary hypophosphatemic rickets with hypercalciuria, and familial hypomagnesemia with hypercalciuria and nephrocalcinosis. Given that the patient demonstrated. medullary nephrocalcinosis differential diagnosis in an infant. furosemide williams syndrome (idiopathic hypercalcemia) differential diagnosis of echogenic renal foci. renal stone vascular calcification gas (consider KUB or CT) sloughed papillae calcified TC Reach anaccurate, clinically useful differential diagnosiswith expert assistance from this unique resource.ExpertDDx: Abdomen and Pelvispresents the most useful differential diagnoses for each region of the abdomen and pelvis, grouped according to anatomic location, generic imaging findings, modality-specific findings, or clinical-based indications Enlargement of the kidneys and nephrocalcinosis have been described previously. We report a 10-year-old boy who presented with gross hematuria, unilateral hydronephrosis, and the initial diagnosis of bilateral extensive medullary nephrocalcinosis. Medullary sponge kidney (MSK) was included in the differential diagnosis given the ultrasound.

Skeleton Key Group Case 13: Hypercalcemia - Renal Fellow