title: [Milk of calcium renal stone: echographic diagnosis].
abstract: "Milk of calcium renal stone" (liquid renal calculosis) is a quite uncommon lithiasis distinguished by the presence of a semiliquid suspension of calcium salts or a "seed-like" sediment in a caliceal diverticulum or an ectasia segment of the collecting system. We reviewed 5 patients (1 male and 4 females, mean age 48.6 years), with a history of urinary tract infection, renal pain or haematuria. All patients underwent renal ultrasonographic assessment in both clinostatic and orthostatic position. Three patients underwent intravenous pyelography before ultrasound. Ultrasonography showed a sonolucent "levelled" image with a posterior acoustic shadow inside a hydro-caliceal dilation (2 pts.) or caliceal diverticulum (3 pts.); the persistence of the "level" in both clinostatic and orthostatic position allowed an immediate diagnosis in all patients. Intravenous pyelography performed before renal ultrasound showed no abnormality in 1 patient and was misleading in two; it otherwise confirmed the diagnosis when performed after renal ultrasonography. Three patients underwent surgery, two patients refused therapy; sonographic follow-up showed no evolution of the morphologic picture. Once considered as exceptional, liquid renal calculosis still remains rare pathology and accounts for 0.6% of all the urinary lithiasis diagnosed by ultrasound in our series. An accurate sonographic assessment allows a reliable diagnosis of this particular lithiasis and an easy discrimination from solid lithiasis, nephrocalcinosis, medullary sponge kidney and hydropyonephrosis. Hence, a correct diagnosis of this rare condition lets uneffective and improper treatments be avoided.
authors.affiliation: Clinica Urologica, Università di Perugia, Roma.
authors.forename: G
authors.initials: G
authors.lastname: Virgili
authors.forename: P
authors.initials: P
authors.lastname: Rosi
authors.forename: F
authors.initials: F
authors.lastname: Tamburro
authors.forename: M
authors.initials: M
authors.lastname: Valitutti
authors.forename: F
authors.initials: F
authors.lastname: Torelli
authors.forename: G
authors.initials: G
authors.lastname: Vespasiani
authors.forename: M
authors.initials: M
authors.lastname: Porena
mesh_terms: D000328:Adult; D000368:Aged; D001826:Body Fluids / Q000737:chemistry / Q000000981:diagnostic imaging; D002118:Calcium / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D013535:Suspensions; D014463:Ultrasonography
chemical_list: D013535:Suspensions; D002118:Calcium
vernacular_title: Milk of calcium renal stone: diagnosi ecografica.