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Ureteral Stone CT Diagnosis: Acute Flank Pain, Hydroureteronephrosis, UVJ Findings, and the Critical Clue of a Passed Ureteric Stone

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  A Case-Based Radiology Guide to Pathophysiology, Imaging Diagnosis, Differential Diagnosis, Treatment, Prognosis, and the Emerging Role of Artificial Intelligence Acute flank pain is one of the most common reasons for emergency abdominal imaging. Among the many possible causes, ureteral stone disease remains one of the most important because a small calculus can produce dramatic pain, urinary obstruction, hematuria, and, in selected patients, potentially serious renal or infectious complications. Yet one of the most important lessons in urinary stone imaging is that the stone seen on CT is not necessarily the stone that is currently causing the obstruction . A patient may present with severe flank pain and undergo CT demonstrating hydronephrosis, hydroureter, perinephric fat stranding, and a small calculus near the bladder. If the ureter is dilated all the way to the ureterovesical junction (UVJ), while the calculus is already located within the bladder, the correct interpretati...
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Pulmonary Sequestration and Intrathoracic Kidney: CT Diagnosis of a Rare Congenital Malformation with Bochdalek Hernia

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  When a Trauma CT Reveals an Entirely Different Story A 22-year-old woman was evaluated after falling from a scooter. Because the clinical question was trauma, the initial purpose of contrast-enhanced CT was straightforward: identify fractures, hemorrhage, solid-organ injury, vascular injury, or other acute traumatic abnormalities. No significant traumatic injury was identified. Yet the CT examination revealed something much more unusual. Within the left lower lobe was an abnormal segment of lung supplied by three systemic feeding arteries arising from the thoracic aorta . The venous drainage was unusual, involving the hemiazygos system. At the same time, the left kidney was not in its expected retroperitoneal position. Instead, it was located within the thoracic cavity through a left posterolateral diaphragmatic defect , accompanied by part of the left adrenal gland, the gastric fundus, and the spleen. The final imaging constellation was: Intralobar pulmonary sequestration + intr...
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