Figure 913

Intravenous urography demonstrates multiple calyceal diverticula (arrows) in a 38-year-old woman who complained of intermittent flank pain. Previously, the ultrasonographic appearance had suggested the existence of polycystic kidney disease. Although usually smaller than 1 cm in diameter, pyelocalyceal diverticula occasionally are much larger, as in this case. They predispose to stone formation. Since ultrasonography is the preferred screening tool for cystic renal diseases, clinicians must be aware of both its pitfalls (exemplified in this case and in the case of parapelvic cysts; see Fig. 9-6) and its limited power to detect very small cysts.

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