Case of the Week: Medullary Sponge Kidney (Ultrasound & CT)

Join me in this radiology lecture revealing the ultrasound and CT appearance of medullary sponge kidney (MSK).

Key points include:
1) MSK is a developmental ectasia with cystic dilatation of the collecting tubules in the pyramids leading to medullary nephrocalcinosis.
2) DDx medullary nephrocalcinosis: Hyperparathyroidism (most common cause in adults), renal tubular acidosis (type 1), MSK, hypervitaminosis D, other causes of hypercalcemia, sarcoidosis.
3) MSK associations: Beckwith-Wiedemann syndrome, congenital hemihypertrophy, Caroli disease, Ehlers-Danlos syndrome.
4) US: Echogenic medullary pyramids.
5) CT: Renal calculi, striated nephrogram, excretory phase “paintbrush” appearance or “growing calculus” sign.
6) Often asymptomatic but may present due to renal stones.

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