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Elevated renal rind
A Paterson1, D P Frush, L E Sweeney
1Radiology Department, Royal Belfast Hospital for Sick Children, Northern Ireland.
Insights
In infants experiencing shock, ultrasound revealed a distinct "elevated renal rind" sign. This finding, characterized by hyperechoic bands around the kidneys, suggests systemic inflammation rather than localized abdominal issues.
Area of Science:
- Pediatric Radiology
- Neonatal Medicine
- Critical Care
Background:
- Infants experiencing shock present complex diagnostic challenges.
- Identifying specific sonographic markers can aid in understanding underlying pathologies.
Purpose of the Study:
- To describe a novel sonographic finding in infants with shock.
- To characterize the
- elevated renal rind
- sign and its clinical implications.
Main Methods:
- Retrospective analysis of five infants (3 weeks to 13 months) with shock.
- Abdominal sonography to evaluate perirenal structures.
Main Results:
- All infants demonstrated bilateral perirenal hyperechoic bands surrounding a hypoechoic fluid rim.
- This
- elevated renal rind
- sign was present during acute illness and persisted post-recovery.
- The sign resolved in surviving infants.
Conclusions:
- The
- elevated renal rind
- is a unique sonographic finding associated with infant shock.
- This sign likely reflects systemic inflammatory processes, not localized intraabdominal disease.
Abstract:
We describe the findings from a group of five infants ranging in age from 3 weeks to 13 months who had shock of differing causes. In each case, sonographic evaluation of the abdomen revealed bilateral perirenal hyperechoic bands several millimeters thick, surrounding a thin, hypoechoic rim of fluid. The findings were identified during the acute phase of each child's illness and persisted after the patient's condition had clinically improved, eventually resolving in the three surviving children. We have dubbed this sign the "elevated renal rind." We believe that the changes are likely secondary to systemic inflammatory mediators and do not reflect localized intraabdominal disease.