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Modified Whitaker test: a novel diagnostic for nephroptosis
Ralph Grauer1, Mikel Gray2, Noah Schenkman2
1Department of Urology, University of Virginia, Charlottesville, Virginia, USA rg3db@virginia.edu.
BMJ Case Reports
|April 30, 2020
Summary
A rare kidney condition, nephroptosis, caused severe flank pain in a patient. A modified Whitaker test successfully diagnosed this unusual hypermobility of the kidney.
Area of Science:
- Nephrology
- Urology
- Diagnostic Imaging
Background:
- Renal colic symptoms, including flank pain and nausea, prompted an initial CT scan.
- The CT scan revealed severe hydronephrosis but no identifiable cause like a kidney stone or ureteropelvic junction obstruction.
Observation:
- The patient's symptoms persisted despite initial treatment and a comprehensive urological work-up.
- Standard diagnostic procedures such as cystoscopy, ureteroscopy, voiding cystourethrogram, and diuretic renography were inconclusive.
Findings:
- A modified dynamic Whitaker test, performed in both supine and upright positions, was utilized.
- This novel application of the Whitaker test successfully diagnosed nephroptosis, a condition characterized by excessive kidney mobility.
Implications:
- This case highlights the diagnostic utility of a modified dynamic Whitaker test for nephroptosis.
- It underscores the importance of considering rare kidney hypermobility conditions when conventional diagnostics fail to identify the cause of hydronephrosis and flank pain.
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