Question
A 52-year-old woman presented with gross haematuria associated with right loin pain for 3 days. On physical examination, she was tender over the right loin region but was afebrile. Blood tests were essentially normal. A KUB was performed as an initial investigation. What can be the most possible diagnosis?
| A. |
Renal Infarct
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| B. |
Renal Calculus
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| C. |
Ureteric Calculus
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| D. |
Renal Carcinoma
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Show Answer
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Correct Answer � B
Explanation
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Ans: B.)Renal Calculus
Image shows: Coned KUB shows radioopacities (arrows) over the left renal area which may represent renal stones.
RENAL CALCULUS
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Renal calculus is a common cause of haematuria, particularly in the presence of loin pain.
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Renal calculi are composed of crystals and/or aggregated with proteins.
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The crystal may contain calcium or magnesium oxalate/phosphate (which are radio-opaque and found in the majority of stones) or uric acid/ xanthine (which are not radio-opaque). As a result of this variable composition, the majority (~90%) of renal stones are radio-opaque, hence a KUB is useful as the initial investigation in a patient with suspected urinary calculus.
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IVU is the key imaging modality for the diagnosis of
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(1) Suspected urinary tract calculus
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(2) Radio-lucent calculus which is not visualized on KUB
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(3) Ureteric calculus may not be demonstrated by ultrasound.
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Information on IVU which is helpful in the management of patients with renal stone include:
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If a patient is allergic to an intravenous contrast medium, ultrasound is a good alternative imaging modality for diagnosis.
