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CT Papillary Necrosis
40-year-old female with SLE and NSAID use presents with hematuria. CT with contrast in the axial plane during the excretory shows evidence of a filling defect in a contrast filled right renal calyx, resulting in a ?lobster claw? appearance of the calyx characteristic of papillary necrosis
Ashley Davidoff MD TheCommonVein.net 113597c
CT Papillary Necrosis
CT urogram in the coronal plane using bone windows shows evidence of papillary necrosis in 2 right upper pole calyces characterized by ?golf ball on a tee? sign. This sign is also called the ?lobster claw? sign
Ashley Davidoff MD TheCommonVein.net 135424c

  • Renal papillary necrosis (RPN) is
  •  necrosis of the renal papillae, caused by the following
      • Ischemia:
        •  severe dehydration,
        • shock
        • vasculitis
        • sickle cell disease:
            • due to the vaso-occlusive events
        • diabetes
          • as a result of microvascular and macrovascular changes
      • Infections:
          • Chronic or severe urinary tract infections
      • Obstruction
      • Analgesic Nephropathy:
        • Chronic use of certain analgesic medications, especially nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin, has been associated with renal papillary necrosis. These drugs can compromise renal blood flow and contribute to tissue damage.