Renal Variants

Question 1

Does a normal variant affect the function of the kidney?

Answer 1

No

Question 2

When do normal variants develop?

Answer 2

During fetal development

Question 3

Are normal variants pathological?

Answer 3

No

Question 4

What is a dromedary hump?

Answer 4

Thickening and bulging of the cortex on the lateral aspect of the left kidney

Question 5

Why does the dromedary hump only occur on the left kidney?

Answer 5

There is room for the kidney to shape- spleen leaves more space then the liver

Question 6

Why should you visualize the CM junction when there is a dromedary hump?

Answer 6

To rule out a mass

Question 7

How can you tell the difference b/w the dromedary hump and a mass?

Answer 7

There will be pyramids within the dromedary hump while there wouldn’t be in a mass

Question 8

What is a hypertrophied column of Bertin?

Answer 8

2 layers of cortex b/w pyramids

Question 9

What portion of the kidney does the hypertrophied column of Bertin form in?

Answer 9

Upper/middle portion of the kidney

Question 10

What does the hypertrophied column of Bertin do to the renal sinus?

Answer 10

Indents the renal pelvis

Question 11

What should the hypertrophied column of Bertin NOT measure?

Answer 11

> 3cm

Question 12

What is the appearance of the hypertrophied column of Bertin on US?

Answer 12

Isoechoic to and continuous with the cortex

Question 13

What is fetal lobulation?

Answer 13

Infolding of cortex but no thinning?

Question 14

What is the appearance of fetal lobulation?

Answer 14

“Scalloped” contour

Question 15

What % of adults is fetal lobulation identified in?

Answer 15

51%

Question 16

Fetal lobulation is a normal appearance until what age?

Answer 16

Up to 6 years of age

Question 17

What is a junctional parenchymal defect?

Answer 17

Incomplete embryological fusion

Question 18

Which side is most common to see the junctional fold defect? Why?

Answer 18

Right side because the window (with the liver) allows for great visualization of the right kidney

Question 19

What is the sonographic appearance of a junctional fold defect?

Answer 19

Wedge shaped hyperechoic defect

Question 20

Where is a common site on the kidney for the junctional fold defect?

Answer 20

Anterior superior cortex

Question 21

What can a junctional fold defect be commonly confused with?

Answer 21

Scarring

Question 22

How does scarring appear on a kidney?

Answer 22

Thinning of the cortex and won’t appear triangular