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Signs in Uroradiology
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ACR Appropriateness Criteria Breast Cancer Screen
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Signs in Uroradiology

Baloon on a string sign

UPJ - Uretero-Pelvic Junction obstruction Bear paw sign: Replacement of renal parenchyma by low attenuation collections in a “hydronephrotic” pattern, seen with Xanto-Granulomatous Pyelonephritis XGP Commet sign: Nucleus is phlebolith and tail is a vein

Crescent sign

Contrast parallel to the margin of dilated calix, incomplete obstruction; recoverable function

Cut-off sign

Arterial, tubular, abrupt ending

Hydronephrotic rim

Enhancement in residual atrophic renal parenchyma around chronic hydronephrosis; negative pyelogram

Jack stones

in bladder, kidney

Kidney sweat

US sign in some renal failures

Mulberry stone

Calcium oxalate dihydrate, lithotripsy

Page kidney

Subcapsular hematoma with mass effect on kidney with resultant HTN

Perirenal cobwebs

Kunin septa (reno-renal, renofascial) - perirenal stranding w/ renal colic ==> obstruction

Reverse rim sign

Hypoattenuating renal cortex compared to intact medullary perfusion --> cortical necrosis from obstetric complication, shock, transfusion reaction, rejection

Rim sign of vascular compromise

Renal artery obstruction (embolus, thrombosis, dissection); subcapsular enhancement as a result of preserved perfusion by capsular perforating vessel; also seen with renal vein thrombosis and ATN

Soft tissue rim sign

Edema (inflammatory change) of ureteral wall surrounding a stone; not around phlebolith (commet sign)

Sponge kidney

Ectatic tubules with stones due to Hyperparathyroidism, RTA, medullary nephrocalcinosis; growing calculus w/ contrast

Spotted nephrogram

Patchy perfusion from small vessel occlusion (necrotizing vasculitis [periarteritis nodosa], scleroderma, hypertensive nephrosclerosis) causing infarction

Staghorn calculus

Struvite, cystine or uric acid; recurrent infections, more common in woman --> XGP: xantogranulomatous pyelonephritis (Triad: Enlarged kidney, Staghorn, Non-functioning kidney) Bear paw sign

Target sign

on MRI, organizing hematoma older than 3 weeks

Tramline or Railorad tracks

Rim calcifications at inner and outer margins of the renal cortex as a result of major vascular insult like shock - cortical nephrocalcinosis