Not just two roads down: a multimodality radiologic-pathologic review of ureteral diseases

Ureteral diseases encompass a broad spectrum of congenital, inflammatory, obstructive, neoplastic, and iatrogenic conditions that frequently pose diagnostic challenges in daily radiologic practice. Computed tomography urography (CTU) has emerged as the reference standard for evaluating ureteral pathology because of its ability to assess the lumen, wall, and periureteral tissues with high spatial resolution. However, ultrasound, magnetic resonance urography, and fluoroscopic techniques remain essential complementary tools in specific clinical scenarios. This pictorial review provides a comprehensive overview of ureteral diseases, emphasizing characteristic imaging features, diagnostic pitfalls, and radiologic-pathologic correlation. The review covers congenital anomalies, ureteral lithiasis, inflammatory and infectious diseases, benign and malignant tumors, extrinsic compression, and post-procedural changes. Special attention is given to the recognition of complications related to surgical and interventional procedures, which represent an increasingly frequent clinical challenge in daily radiologic practice. This review provides a structured multimodality framework to support accurate diagnosis, guide management decisions, and improve communication with referring clinicians.