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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[takechiajackson]

For years I kept passing a ton of stones, having recurring UTIs, and other issues.
They finally discovered that it was indeed Medullary sponge kidney disease (Cystic Congenital Disease of the Kidney) for me.
I now have a nephrologist in conjunction to a urologist.
I'm understanding the diagnosis better, and learning how to do what I need to do in order to minimize stone formation, and other complications.

[LaneyandherGermanShepherds]

Mine are like this .I have Medullary Sponge kidney disease, with nephrocalnosis and stones .Just passed 12 this last wk.Mine are doing better on chanca Piedra. In 2020 I passed 2.5 cm worth of stones they were huge ! I have video .I finally found help after a terrible life of stone passing. I still pass them but there getting smaller and stable. I have passed over 400 stones the since 2016.Great video .

[kirstenb]

Thank you for this information. I also have MSK. I've had a nephrologist for about 14 years that I see yearly. I've been warned that I'm susceptible to stones. Well, over the past two weeks I've been dealing with my first stone that is stuck in the ureter so my new urologist will be removing the stone and placing a stent this week. I hope long term this will decrease pain when I have the inevitable stones.

[skeletopedia]

After treating underlying cause for medullary sponge, will the radiological findings of nephrocalcinosis resolve? Or will those calcs persist (indefinitely)?

[malishafuller]

This looks like me ❤ I have MSK and now going over 25 lithotripsys

[naeemasr]

Respected sir u r a excellent excellent excellent excellent excellent excellent excellent excellent 🌹teacher ❤️❤️❤️❤️

[naeemasr]

Respected sir what’s mean by maximum intensity projection (MIP) image?

[angelicadepaola]

Does anyone else experience kidney pain with this disease?? I have medullary sponge kidney and always have kidney pain in my left kidney sometimes the pain is unbearable. I’ve been seen by so many specialists and they all tell me I shouldn’t be in pain and that this disease doesn’t cause pain. I’m exhausted 😢

[CorboFam]

I have this medullary nephrocalcinosis I’m 35 drs tell me I’m a medical mystery I don’t have any of the factors that cause it but I’m very sick and have been for 14 months now I’ve been passed around to so many specialists no one will help me. Please if u know any doctors who can help me please

[JaidenRasmussen-yi]

I get it that you are really smart and stuff but it takes a real smart person to be able to dumb it down so regular people can understand what the f*** you're talking about