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LESIONS CAUSING RADIOLUCENT DEFECTS IN THE RENAL PELVIS

ROBERT C. BROWN M.D., MAYNARD C. JONES JR. M.D., ROBERT BOLDUS M.D., and RUBIN H. FLOCKS M.D.

Radiolucent filling defects of the renal pelvis may occur because of either intrinsic or extrinsic causes.

A detailed history and complete physical examination should be the first steps in evaluating the patient. Obtaining the proper laboratory studies, especially examination of the urinary sediment, bacterial cultures of the urine, serum and urinary uric acid determinations will also be of assistance.

Technical and morphologic causes can be differentiated by close attention to urologic and radiologic techniques. Proper bowel preparation, adequate dosage of contrast media, application of abdominal compression bands over the lower abdomen, oblique projections of the kidney and nephrotomography will help solve technical and morphologic causes of radiolucent defects.

Selective renal arteriography and possibly ultrasonic scans are of assistance in differentiating mass lesions of the kidney.

By careful attention to these details most lesions can properly be diagnosed.


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