HYDRONEPHROSIS

TRISHA DENISE D. CEDEÑO

JUNIOR INTERN
HYDRONEPHROSIS
• DILATATION of the urinary collecting system
of the kidney (the calyces, the infundibula,
and the pelvis) or the upper urinary tract.
• NOT SYNONYMOUS WITH OBSTRUCTION

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HYDRONEPHROSIS
• can be caused by obstruction of the ureters
or bladder outlet.
• can also result from reflux (retrograde
leakage of urine from the bladder up the
ureters to the renal pelvis).

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ANATOMY & PATHOPHYSIOLOGY

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HYDRONEPHROSIS: GRADING SYSTEMS
GRADING CHARACTERISTICS
0
• No dilatation, calyceal walls are apposed to each other
NORMAL
• Dilatation of the renal pelvis without dilatation of the calyces (can
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also occur in the extrarenal pelvis)
MILD
• No parenchymal atrophy
• Dilation of the renal pelvis and calyces (pelvicalyceal pattern is
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retained)
MILD
• No parenchymal atrophy
• Moderate dilatation of the renal pelvis and calyces
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• Blunting of fornices and flattening of papillae
MODERATE
• Mild cortical thinning may be seen
• gross dilatation of the renal pelvis and calyces, which appear
4 ballooned
SEVERE • loss of borders between the renal pelvis and calyces
• renal atrophy seen as cortical thinning
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HYDRONEPHROSIS: GRADING SYSTEMS

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CASE

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CASE

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CASE

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CASE

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 CASE

Case courtesy of David Puyó, Radiopaedia.org, rID: 22160

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 CASE

Case courtesy of David Puyó, Radiopaedia.org, rID: 22160

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CASE

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CASE

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CASE

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REFERENCES

Brant and Helms Fundamentals of Diagnostic Radiology, 5th Edition

https://pubs.rsna.org/doi/10.1148/50.5.632

http://www.meddean.luc.edu/lumen/MedEd/urology/ushydro.htm

https://radiopaedia.org/cases/22160/studies/22170?lang=us&referrer=%2Farticles%2Fhydron
ephrosis-grading-1%3Flang%3Dus%23image_list_item_3041784#images

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THANK YOU!
TRISHA DENISE D. CEDEÑO
JUNIOR INTERN