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Differential Diagnosis of Medullary Sponge Kidney (MSK)


2012-09-16 14:23

Medullary Sponge Kidney (MSK) is usually a benign congenital disorder featured by dilatation of collecting tubules in one or more renal papillae, affecting one or both kidneys. The disease is often diagnosed in one's 20s or 30s. Here, we mainly talk about differential diagnosis of MSK.

▪ Multiple Kidney Stone.

People with this disease may have symptoms like lower back pain, renal colic, hematuria, etc and history of urinating calculus. KUB shows that there is multiple increased density of shadow within the kidney, but urography displays that calculi are located within the renal pelvis and renal calyx. There is no characteristic distribution of MSK, but often accompanied with pyelectasis, caliectasis, hydronephrosis, and hydrocalycosis.

▪ Renal pelvis and renal calyx diverticulum accompanied with milk calcium.

Patients may have lower back pain and microscopic hematuria. KUB may show that there is local multiple millet granular calcification in one pole of the kidney, which may change with body position to circular or semicircle. Urography show that there is circular smooth-edge cystic cavity around the renal calyx, in which there is shadow of microlith. There is also slow evacuation of contrast medium. Occasionally, small pipes are connected with renal calyx. B ultrasound and CT scan show solitary cyst in the renal parenchyma and multi calculi.

▪ Renal tuberculosis.

Patients may experience lower back pain and blood in urine. KUB and B ultrasound show multiple irregular calcification nidus in the renal parenchyma, which often accompanied with tubercular general symptoms and obvious urinary irritation. Urography shows damaged renal pelvis and renal calyx as well as irregular, narrow, or atretic urinary tract. The diagnosis can be confirmed if there is acid fast bacilli in the urine.

▪ Calcium and salt deposition in the kidneys.

In KUB, there is diffuse calcium and salt deposition in the renal pyramid. This is the renal manifestation of other diseases.

▪ Necrotizing papillitis of kidney.

After the healing of necrotizing renal papillae, KUB and B ultrasound show the presence of calcification nidus in multiple renal papillae. Patients often have medical history of Diabetes, urinary tract infection, allergy, etc. The onset is acute and symptoms develop all over the body. There may be necrosed nipple tissue in the urine.

Having knowledge of differential diagnosis of MSK contributes to confirming the diagnosis the disease. If there is anything unclear, contact our online doctor for free help.


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