Presentation
A diabetic patient presents with acute left flank pain. The patient's renal function tests (RFT) were deranged, showing high levels of urea and creatinine.
Patient Data
Heterogeneous content is observed within the left-sided middle ureter with no significant posterior acoustic shadowing, causing upstream dilation of the left-sided middle ureter and pelvicalyceal system.
Adjacent urothelial thickening is observed along the visualized dilated ureter and pelvis, with increased renal cortical echogenicity.
Case Discussion
On ultrasound imaging, renal papillary necrosis (RPN) manifests as hyperechoic areas corresponding to necrotic papillae, which appear brighter than the surrounding healthy tissue. The typical striated appearance of the renal papillae may be distorted or obscured due to tissue destruction. Additionally, dilation of collecting ducts and calyces is often observed, reflecting obstructed urine flow caused by necrotic debris.
It was later confirmed on urine microscopy, which showed necrosed papillae and debris.
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