A 28-year-old female presents with a history of renal calculi and right flank pain. A selected image from her renal ultrasound is presented.
Grayscale ultrasound of the right kidney demonstrates hyperechogenicity in the renal medulla.
1. Based on the selected image, where is the salient abnormality?
2. Which modality shows the earliest sign of this condition?
3. Which of the following is the least likely explanation for the findings in the selected image?
Alport’s syndrome is associated with cortical nephrocalcinosis. The other conditions are associated with medullary nephrocalcinosis with hyperparathyroidism being the most common.
4. Which medication is associated with this condition in infants?
5. What is the most likely explanation of the patients flank pain?
While the renal ultrasound shows that the patient has nephrocalcinosis, flank pain is more commonly due to associated nephrolithiasis.
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