Diagnosis: Medullary nephrocalcinosis

Modality: X-Ray

Presentation and History: 45 year old female patient with elevated calcium levels due to hyperparathyroidism.

Imaging Findings: Multiple bilateral calcifications are seen in the medullary regions of both kidneys. Note typical configuration of pyramids which is equivalent to echogenic pyramids by ultrasound.

Key Points and Takeaways: Nephrocalcinosis was at times referred to as Albright calcinosis or Anderson-Carr kidney. In this process, there is deposition of calcium salts in parenchyma of kidneys in various location. A majority of the types of nephrocalcinosis is in a medullary distribution followed by cortical distribution. However, calcinosis can occur in a mixed distribution involving both the medullary and cortical regions. Hyperparathyroidism, medullary sponge kidney and renal tubular acidosis are common causes for such type of nephrocalcinosis.

Credit: Case submitted by Dr. Wael Nematalla to radRounds Radiology Network