Not every calcification is a calculus!
The present case has been reported in the Journal of the Association of Physicians of India.

A 59-year-old postmenopausal lady presented with back pain. She had hypertension, well controlled on a single antihypertensive and a normal renal function. Plain radiograph showed “ring-like” calcification in the region of her kidneys.

CT angiography revealed bilateral calcified saccular renal artery aneurysms (RAA) < 2cms in size, arising from the segmental vessels at the hilum. Colour Doppler did not show any evidence of renal artery stenosis and renogram showed bilateral normal perfusion and function.

Considering the low risk of complications in this patient, she was managed conservatively and was advised regular blood pressure monitoring and yearly follow up with imaging.

Key takeaways:-
• Imaging is crucial for the diagnosis of RAA and presence of “ring-like” calcification on a plain abdominal radiograph should alert the physician.

• As calcification in RAA is seen in >50% of the cases, further imaging is essential to distinguish it from renal calculi prior to embarking on therapy like extracorporeal shockwave lithotripsy.

• Angiography being the gold standard affords a 100% diagnostic rate.

• However, non-invasive imaging like CT and MR angiography (MRA) are ideal with sensitivity and specificity of MRA being 78% and 100% respectively.

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Dr. M●●●r P●●●l
Dr. M●●●r P●●●l General Medicine
Is the calcification related to atherosclerosis??
Oct 16, 2018Like