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When analyzing a beam subjected to various loads, it is crucial to understand the internal forces and moments generated within the structure. These internal forces can be broadly classified into normal forces, shear forces, and bending moments. To determine these forces and moments, we use the method of sections and apply a specific sign convention based on their direction and the side of the section being analyzed.
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The Scintigraphic Drooping Lily Sign.

Karine Sahakyan, Melissa R Spevak, Harvey A Ziessman

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    The "scintigraphic drooping lily" sign on renal scans can indicate a duplicated kidney system. This finding, seen in infants with hydronephrosis, helps differentiate obstructed upper pole moieties from normal kidney structures.

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    Area of Science:

    • Pediatric Radiology
    • Nuclear Medicine
    • Urology

    Background:

    • The "drooping lily" sign is a recognized imaging finding in duplicated renal collecting systems.
    • It typically refers to the displacement of a functioning lower pole moiety by an obstructed upper pole system on contrast imaging.
    • Accurate identification is crucial for appropriate patient management.

    Observation:

    • A 2-month-old infant presented with prenatal hydronephrosis.
    • A "scintigraphic drooping lily" sign was observed on a Technetium-99m dimercaptosuccinic acid (Tc-DMSA) renal scan.
    • This indicated a duplicated renal collecting system with an obstructed upper pole moiety.

    Findings:

    • The scintigraphic findings were confirmed by ultrasound and voiding cystourethrography.
    • The case highlights the utility of nuclear medicine scans in diagnosing complex renal anomalies.
    • The "drooping lily" sign on Tc-DMSA scan accurately depicted the obstructed upper pole moiety.

    Implications:

    • Recognizing the "scintigraphic drooping lily" sign is vital for accurate diagnosis in infants with hydronephrosis.
    • This sign aids in differentiating duplicated collecting systems from other renal abnormalities.
    • Correlating scintigraphic findings with anatomical imaging prevents misinterpretation of the lower pole moiety.