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Horseshoe Kidney

Ariane Staub Neish, MD
J Stevan Nagel, MD

January 19, 1995

Presentation

A 46-year-old woman with mild mental retardation and short stature presented with question of stress fracture of right hip.

Imaging Technique

Tc-99m MDP (methylene diphosphonate), 25 mCi injection. Images acquired at 4 hours delay with a parallel hole collimator.

Imaging Findings

Anterior view
Posterior view

The lower poles of the kidneys are tilted medially (arrows). Increased density is noted in the midline overlying the lower spine on the anterior view (arrows), but not the posterior view.

Diagnosis

Horseshoe kidney in a patient with Turner's syndrome.

Discussion

Fusion of the lower poles of the kidney occurs in 0.01-0.25% of the population with an increased incidence in Turner's syndrome. The isthmic portion may be fibrous or contain functional tissue. The diagnosis is important because of the increased incidence of urinary obstruction, stone formation, vesicoureteral reflux, infection, trauma, and Wilms tumor.

References

1. Datz FL. Nuclear medicine: A teaching file. In: Mosby Year Book, St. Louis, 1992;142.

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