Differential Diagnosis for Prominent Staghorn Calculus in the Right Renal Pelvis
- Single most likely diagnosis
- Kidney Stone (Staghorn Calculus): This is the most likely diagnosis given the presence of a prominent staghorn calculus in the right renal pelvis. Staghorn calculi are a type of kidney stone that fills the renal pelvis and has branches that extend into the calyces, resembling the antlers of a stag. They are often associated with recurrent urinary tract infections (UTIs) and can cause obstructive uropathy.
- Other Likely diagnoses
- Urinary Tract Infection (UTI): Patients with staghorn calculi are at increased risk of developing UTIs due to the obstruction and stagnation of urine. The presence of a staghorn calculus can provide a nidus for bacterial growth, leading to recurrent infections.
- Obstructive Uropathy: The staghorn calculus can cause obstruction of the renal pelvis, leading to a buildup of urine and potential damage to the kidney. This can result in symptoms such as flank pain, nausea, and vomiting.
- Chronic Kidney Disease (CKD): Long-standing obstruction and infection can lead to chronic kidney damage and CKD.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Xanthogranulomatous Pyelonephritis (XGP): A rare but potentially life-threatening condition characterized by a destructive inflammatory process involving the kidney. It can mimic a staghorn calculus on imaging studies and requires prompt diagnosis and treatment.
- Renal Cell Carcinoma: Although rare, a staghorn calculus can be associated with an underlying renal cell carcinoma. It is essential to consider this possibility, especially if there are atypical features or a lack of response to treatment.
- Sepsis: Untreated UTIs or obstructive uropathy can lead to sepsis, a life-threatening condition that requires prompt recognition and treatment.
- Rare diagnoses
- Medullary Sponge Kidney: A rare congenital disorder characterized by the presence of small cysts in the renal medulla, which can increase the risk of developing kidney stones.
- Primary Hyperparathyroidism: A rare endocrine disorder that can increase the risk of developing kidney stones due to hypercalcemia.
- Cystinuria: A rare genetic disorder that affects the kidneys and can increase the risk of developing kidney stones.