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Radiology Urography 06f97cb8

IVP of polycystic kidney disease shows:

A
Cobra head
B
Dropping lilly
C
Flower base appearance
D
Spider leg deformity'
High-Yield Explanation
Ans: D (Spider leg deformity) The calyces are enlarged & stretched over the cysts, which look like legs of a spider; hence called spider leg deformity"- Textbook of Surgery by 5 Das 5th/1155Autosomal Dominant Polycystic Kidney DiseaseMorphologyThe disease is universally B/L & the both kidneys are grossly enlarged , with multiple cyst studding the surface of the kidney.The cyst are spherical, vary in size from a few imltimeters to centimeters, & are distributed evenly throughout the cortex & medulla. Only 1 to 5% nephron will develop cysts.The cyst contain straw coloured fluid that may become haemorrhagic.Genetic ConsiderationOver 90% of cases are inherited as an AD-trait , with the remainder likely representing spontaneous mutations. Two form of ADPKD has been identified.ADPKD-1 accounts for 85% of cases & the gene has been mapped to chromosome 16p13.3. ADPKD-2 accounts for remainder cases & the gene has been mapped to chromosome 4q 21-23.ADPKD-2 appear to have a later age of onset of symptoms & renal failure than ADPKD-1.Radiological Feature Rim / Cresent Sign HydronephrosisSoap Bubble appearanceHydronephrosisSpider leg appearancePolycystic kidneyFlower vase appearance of ureterHorse shoe kidneyDrooping flower appearanceEctopic ureterCobra head appearanceUreterocoeThimble biadderTubercular cystic (chronic)Sandy patchesSchistosomiasis of bladderFish hook bladderBPH

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