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Fraley's syndrome: case report and update on current diagnostic methods.
L S Zuckier1, Y D Patel, E J Fine
1Department of Radiology, Albert Einstein College of Medicine, Bronx, New York.
Urologic Radiology
|January 1, 1988
Summary
An uncommon kidney artery anomaly can cause flank pain and infection. Diagnostic imaging, including [131I]Hippuran imaging, helps evaluate this rare cause of nephralgia.
Area of Science:
- Nephrology
- Urology
- Radiology
Background:
- Pyelonephritis is a common diagnosis for flank pain and fever.
- Uncommon causes of nephralgia and urinary infection require specific diagnostic approaches.
Observation:
- A patient presented with symptoms suggestive of pyelonephritis.
- Diagnostic work-up identified a crossing arterial branch obstructing the superior infundibulum of the right kidney.
Findings:
- This anatomical variation, first described by Fraley in 1966, is a rare cause of kidney obstruction.
- Diagnostic imaging modalities like intravenous urography, retrograde pyelography, and angiography are crucial for diagnosis.
- [131I]Hippuran imaging offers a precise method for assessing functional and excretory changes in the superior infundibulum, outperforming whole-kidney renograms.
Implications:
- Renal scintigraphy provides a noninvasive means for serial functional assessment.
- Ultrasound imaging can offer complementary morphological data for long-term patient follow-up.