Crossed renal ectopia: can it be a diagnostic problem?

Area of Science:

• Pediatric Urology
• Congenital Anomalies
• Medical Imaging

Background:

• Crossed renal ectopia (C-RE) is a rare congenital anomaly where both kidneys are located on one side of the body.
• This condition affects an estimated 0.05% to 0.1% of the population.
• Many patients with C-RE are asymptomatic, with diagnosis often incidental.

Purpose of the Study:

• To present findings from a retrospective study of 5 children with C-RE.
• To highlight the varied clinical presentations of C-RE.
• To emphasize the limitations of ultrasound in diagnosing C-RE and the utility of other imaging modalities.

Main Methods:

• Retrospective analysis of 5 pediatric cases diagnosed with C-RE.
• Review of diagnostic imaging techniques including ultrasonography (US), intravenous urography (IVU), computed tomography (CT), magnetic resonance imaging (MRI), and technetium-99m dimercaptosuccinic acid (TcDMSA) scans.
• Comparison of diagnostic confidence across different imaging modalities.

Main Results:

• Ultrasound (US) demonstrated low sensitivity in diagnosing C-RE in the studied cases.
• Intravenous urography (IVU) and Magnetic Resonance Imaging (MRI) provided the highest diagnostic confidence.
• Clinical presentations varied, with some cases diagnosed incidentally due to non-specific symptoms.

Conclusions:

• Crossed renal ectopia diagnosis can be challenging due to its rarity and variable presentation.
• Advanced imaging techniques like IVU and MRI are crucial for accurate diagnosis, surpassing the sensitivity of US.
• Further investigation into the clinical spectrum and optimal diagnostic pathways for C-RE is warranted.