Learning objectives
To review uncommon urogenital disorders manifestingin childhood
To illustrate the radiologic features of these conditions using MRIimaging technique
To provide tips in order to avoid potential diagnostic errors
Background
Pelvic pain anddysuria are very common symptoms among pediatric population.
Radiological imaging is the clue to the prompt diagnosis and faster treatment.
Abnormalities such asHerlyn-Werner-Wunderlichsyndrome,
late complications after surgery ofhypospadias,
persistent urethraldiverticulum are likely to be missed or missinterpreted by radiologists due to their rarity.
Although sonography can provide quite accurate diagnosis,
particularly in neonates,
MRI has come to play a significant role in promt diagnosis of rare urogenital disorders.
Computed Tomography may be helpful in selected cases,
but should be avoided according to ALARA...
Findings and procedure details
Renal Lymphangiomatosisis a developmental malformation of normal lymphatic tissue in perirenal or peripelvic area resulting in cystic masses.
Synonyms for this pathology are renal lymphangioma,
hygroma renalis,
and renal lymphangiectasia.
Best diagnostic clue:Multilocular cystic mass in perirenal area with thin septa.
Location:Perirenal,
peripelvic; usually bilateral.
Size:Variable,
can become larger than kidney itself.
Best imaging tool:MR or CT
Findings:Subcapsular mass with fluid attenuation on CT and high signal intensity on T2WI MR.
Usually low signal intensity on T1 WI (high signal intensity on T1WI is seen...
Conclusion
Understanding the implications of rare congenital urogenital anomalies is the key in detecting associated anomalies,
initiating therapy and intervention,
and avoiding complications in acute cases.
It is important to consider rare urogenital disorders as well dealing with pelvic pain and dysuria in children and adolescents.
References
Mann GS,
Blair JS,
Garden AS,
editors.
Text Book of Medical Radiology,
Imaging of Gynecological Disorders in Infants and Children.
Berlin Heidelberg: Springer-Verlag; 2012.
Palmer LS,
Palmer JS.
Pediatric and adolescent urological imaging.
Springer Science+Business Media,
New York; 2014.
Baert AL,
Knauth M,
Sartor K.
Pediatric Uroradiology.
2nd edn.
Springer-Verlag Berlin Heidelberg,
2008.
RowellAC,
Sangster GP,
Caraway JD,
WalkerPW,
ElmajianDA,HeldmannMG.
Genitourinary Imaging: Part 1,
Congenital Urinary Anomalies And Their Management.American Journal of Roentgenology.
2012;199: W545-W553.
10.2214/AJR.11.8197
Karkouche R et al: Bilateral renal lymphangiomatosis: imaging and...