62-year-old female with abdominal pain, fever, chronic cystitis, self-catheterization. Status post appendectomy. Creatinine is 1.7. This examination is limited by the absence of intravenous contrast. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is cholelithiasis without evidence of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is extensive fat stranding surrounding the right kidney. In the right midpole region there is a faintly seen cystic mass which measures approximately 4 cm in diameter. CT or MRI examination with contrast would be required to further delineate this potential lesion. There is mild right hydronephrosis and hydroureter. No renal calculus are present. There are several small calcifications in the course of the distal ureter and in the pelvis, but these cannot be convincingly demonstrated to be within the ureter. There is a left midpole faint hypodensity measuring approximately 1.8 cm in diameter which may be a simple cyst. The left kidney is otherwise within normal limits. The findings in the right kidney are most likely due to pyelonephritis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: UTERUS, ADNEXAE: No significant abnormality notedBLADDER: There is a small amount of air within the bladder compatible with history of self-catheterization.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes in the lumbosacral spine and pelvis.OTHER: No significant abnormality noted
Fat stranding, mild hydronephrosis and hydroureter of the right kidney compatible with pyelonephritis. No definite evidence of renal stones. Bilateral renal cortical hypodensities are faintly seen, but cannot be further characterized without IV contrast. Cholelithiasis without evidence of cholecystitis.