The most sensitive imaging modality to detect early renal tuberculosis is ?

Ans. is 'a' i.e. Intravenous urography In early renal tuberculosis, the only radiological abnormality may be irregularity or destruction of one or more papillae and the most sensitive modality to detect it is IUV as it can show detailed calyceal anatomy. Advanced changes are :? a) Calcification - this may occur in any pa of genitourinary tract, most commonly in kidney, next in ureter. b) Cavities c) Fibrosis leading to obstruction - fibrotic strictures of the pelvis or ureters lead to hydronephrosis - strictures of the calyceal neck leads to hydrocalyces (or hydrocalicosis) d) Bladder changes - bladder wall may appear thickened and trabeculated and bladder may be small, contracted. - in later stages VUR may develop Computed tomography shows advanced changes well, but is less sensitive in early stages as it cannot show detailed calyceal anatomy.