Se ha denunciado esta presentación.
Utilizamos tu perfil de LinkedIn y tus datos de actividad para personalizar los anuncios y mostrarte publicidad más relevante. Puedes cambiar tus preferencias de publicidad en cualquier momento.

Genitourinary Tuberculosis

5.177 visualizaciones

Publicado el

Second most common form of extrapulmonary tuberculosis after lymph node tuberculosis in developing countries.

Publicado en: Salud y medicina
  • Sex in your area is here: ❤❤❤ http://bit.ly/369VOVb ❤❤❤
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí
  • Follow the link, new dating source: ❶❶❶ http://bit.ly/369VOVb ❶❶❶
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí

Genitourinary Tuberculosis

  1. 1. Dr. Sudha Kiran Das, Asst Professor, Radiology, JSSMC - Mysore
  2. 2.  Second most common form of extrapulmonary tuberculosis after lymph node tuberculosis in developing countries.  The kidneys are the most common site of GUTB and are infected through hematogenous spread; from the kidneys, the bacilli can spread to the renal tract, prostate and epididymis.  CT and intravenous urography can aid diagnosis— calcification, multiple strictures and fibrosis are suggestive features on imaging.  GUTB is strongly associated with infertility in women, as the Fallopian tubes are affected in most cases, and rates of successful pregnancy remain low even after treatment.
  3. 3.  Following primary pulmonary infection, mycobacteria spread to the renal tract hematogenously.  Caseating granulomata can form, which are usually bilateral and cortical.  These granulomata can erode into the calyceal system resulting in disease spread to the rest of the renal tract. Postmortem Specimen Caseation in the Renal Cortices of a GUTB patient.
  4. 4. Irregular calix  Fuzzy irregular calices, truncated calix, phantom calix – features of papillary necrosis. Necrosed papilla on USG
  5. 5. Fuzzy & irregular calices due to papillary necrosis. Normal calices
  6. 6.  Papillary (forniceal) excavation.  The necrotic papillary tip may remain within the excavated calix, producing a signet ring sign when the calix is filled with contrast material.
  7. 7. Phantom calix Infundibular stenosis
  8. 8. Ghost - like RGP Decreased nephrographic opacity and nonfilling of the collecting system elements at the lower pole of left kidney – phantom calices (ghost : exist, but not visualised, the same are visualized on RGP).
  9. 9. On IVP : Collecting system shows contrast material in a large papillary cavity, the “golf ball” (∗). Blunted calyx, the “tee,” is adjacent (arrow).
  10. 10. => pulled up Cephalic retraction of the inferior medial margin of the renal pelvis at the ureteropelvic junction (UPJ)
  11. 11.  Cortical scarring with dilatation & distortion of adjoining calices coupled with strictures of the pelvicaliceal system.  Cause luminal narrowing either directly or by causing kinking of the renal pelvis at the UPJ.
  12. 12.  Ulcerations causing mucosal irregularity of ureter.
  13. 13.  Mucosal irregularity and erosions resulting in chronic fibrotic strictures of ureter. Mucosal thickening of ureter
  14. 14.  Rigid ureter: irregular and lacks normal peristaltic movement, fibrotic strictures noted.  Note the distortion, amputation and irregularity of the upper pole calices. Pipe stem: for tobacco smoking, recent ones look like this.. Old pipe stem
  15. 15.  IVP: cobra head sign, the lucent halo is however thick, irregular and less well defined.  DD’s: calculus / tumor. Rao A, Yvette K, Chacko N. Tuberculosis of urinary bladder presenting as pseudoureterocele. Indian J Med Sci 2005;59:272-3
  16. 16.  Diminutive and irregular urinary bladder – simulating a thimble.
  17. 17.  Autonephrectomy.  Diffuse, uniform, extensive parenchymal calcifications forming a cast of the kidney with autonephrectomy.  End stage of GuTB.
  18. 18.  HSG may demonstrate a flask-shaped dilatation of the fallopian tubes due to obstruction at the fimbria.
  19. 19.  Focal irregularity and areas of calcification occur within the lumen of the fallopian tubes.
  20. 20.  Caseous ulceration of the mucosa of the fallopian tube produces an irregular contour of the lumen of the tubes.  Diverticular cavities may surround the ampulla and give a “tuft” like appearance.
  21. 21.  Scarring fallopian tubes.  Irregular and rigid.
  22. 22.  Multiple constrictions along the course of fallopian tube on HSG due to fibrotic strictures.
  23. 23.  Scarring results in a “T” shaped uterine cavity.
  24. 24.  Prostatic abscess, T2-weighted MRI shows a peripheral enhancing cystic mass with radiating, streaky areas of low signal intensity.
  25. 25. Do mail us back at (jssmcrad@gmail.com) - if you come across more signs that can be added to this “sign soup”.

×