The roentgen diagnosis of intra-abdominal pathologic conditions is difficult largely because of the many organs contained within the abdomen. When their shadows can be distinguished, the single roentgenogram necessarily presents them with more or less overlapping of outlines. If the pathologic process suspected expresses itself in calcifications, it is often difficult to localize these as being in a particular organ.
This situation is especially trying in urologic conditions, in which concretions play a leading rôle and the area traversed by the involved tract is extensive. While urinary concretions may be fairly characteristic, they are not always so and may be hard to differentiate from calcifications in nearby structures. Also, there may occur extraneous densities, of more or less accidental origin, to confuse the picture further.
From the fairly extensive literature on the subject, Holmes and Ruggles1 have gathered the following list of densities that may simulate renal concretions: 1.
HARTUNG A, WACHOWSKI TJ. EXTRANEOUS SHADOWS COMPLICATING UROGRAPHYWITH SPECIAL REFERENCE TO RADIOPAQUE PILLS. JAMA. 1936;106(8):596–598. doi:10.1001/jama.1936.02770080010004
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