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CT Renal Medullary Nephrocalcinosis

Findings: There is diffuse bilateral medullary nephrocalcinosis. Otherwise there are no cystic or mass lesions of the kidneys. The kidneys are normal in size and position bilaterally. There is also a large 6 x 13mm renal stone at the left uteropelvic junction. There are no other stones or calcifications noted within the ureters or bladder. There is mild hydronephrosis of the left renal collecting system. The bladder demonstrates a normal appearance. The liver, pancreas, spleen, and adrenals demonstrate a normal appearance without focal lesions. There is no free fluid or free air in the peritoneal cavity. The osseous structures are remarkable for bilateral L5 spondylolysis without spondylolisthesis. Impression: 1. A 6 x 13 mm renal stone in the left UPJ, with mild left hydronephrosis. 2. Bilateral medullary nephrocalcinosis. Differential etiology includes hypercalcemia, hyperuricemia, renal tubular acidosis or medullary sponge kidney. 3. Bilateral L5 spondylolysis.