Spectrum of high-resolution sonographic features of urinary tuberculosis.

OBJECTIVE: To evaluate the high-resolution sonographic features of urinary tuberculosis. METHODS: During a period of about 3 years 6 months, there were 45 patients with sonographic features of urinary tuberculosis that was subsequently proved by urine culture or biopsy. The clinical symptoms, urinalysis findings, sonographic features, urine smear findings, and biopsy findings were recorded. RESULTS: The most common symptoms were dysuria and frequency of micturition. Sonographic features included parenchymal masses, cavities, mucosal thickening of the collecting system and urinary bladder, stenosis of the collecting system, a contracted urinary bladder, vesicoureteric reflux, and calcifications. The proof of tuberculosis was by urinalysis, culture, and biopsy. CONCLUSIONS: High-resolution sonography in appropriate clinical situations is useful in diagnosis of urinary tuberculosis. The various high-resolution sonographic findings in urinary tuberculosis are illustrated. The distinguishing features are visualization of involvement of multiple sites and multiple stages of disease in the same patient.

Sonographic features of necrosed renal papillae causing hydronephrosis.

OBJECTIVE: To describe the sonographic appearance of ureteric obstruction due to necrosed papillae. METHODS: In this study, carried out over 3 years 6 months, patients with diabetes mellitus who had renal colic were studied by sonography. RESULTS: In 15 patients with hydronephrosis, there was a soft tissue mass of necrosed papillae filling the ureteric lumen at the site of obstruction. Necrosed papillae were seen in medullary cavities of the ipsilateral kidney in 5 patients. Ureteroscopic removal of necrosed papillae was done in 13 patients. One patient was not fit for an invasive procedure. CONCLUSIONS: When patients predisposed to renal papillary necrosis have renal colic, and sonography fails to show a ureteric calculus, it is best to look for necrosed papillae in the ureter, which may be causing obstruction.