Not a radiological finding of papillary necrosis on excretory urogram is
Ans is 'c'. i.e. Increased dense nephrogramThe diagnosis of papillary necrosis depends on the demonstration of calyceal and papillary abnormalities without associated parenchymal loss. The calyceal and papillary abnormalities fall into two groups:Those that are characteristic of papillary necrosisTracks and horns of contrast medium arising from the calyceal Fornices (representing necrosis around the papillary margin.)Egg in a cup appearance (due to central necrosis producing central pool of contrast within the papillae)Ring shadow (Papillary sloughing produces a central lucent filling defect with a surrounding ring of contrast medium)Those that are non-specificThe end result of papillary sloughing is clubbed, blunt or truncated calyces.Renal papillary necrosis refers to coagulative necrosis of the renal medullary pyramids and papillae brought on by several associated conditions and toxins that exhibit synergism toward the development of ischemia. Renal papillary necrosis may be localized or diffuse and unilateral or bilateral.Renal papillary necrosis can lead to secondary infection of desquamated necrotic foci, deposition of calculi, and/or separation and eventual sloughing of papillae, with impending acute urinary tract obstruction. Sinus like tracts and cavitation's may be seen surrounding the sloughed papilla. Multiple sloughed papillae can obstruct their respective calyces or can congregate and embolize to more distal sites (eg, ureteropelvic junction, ureter, ureterovesical junction)Renal papillary necrosis is potentially disastrous and, in the presence of bilateral involvement or an obstructed solitary kidney, may lead to renal failure.Certain conditions have a known association with renal papillary necrosis, and the underlying mechanism of these conditions is ischemia, which ultimately leads to renal papillary necrosis.Analgesic abuseObstruction of the urinary tract with infectionSickle cell diseaseDiabetes mellitus
Tracks and horns from calyces
Ring shadow
Increased dense nephrogram
Egg in cup appearance
Urogenital System