Differential Diagnosis for Infant with Minimal Central Pelviectasis
- Single most likely diagnosis
- Normal variant or physiological pelviectasis: This is the most likely diagnosis, as minimal central pelviectasis can be a normal finding in infants, especially in the first few months of life. The renal pelvis can appear prominent due to the relatively small size of the kidneys and the normal variation in renal anatomy.
- Other Likely diagnoses
- Urinary tract infection (UTI): UTIs can cause minimal central pelviectasis due to inflammation and obstruction of the urinary tract. Infants are more prone to UTIs due to their immature immune system and shorter urethras.
- Transient hydronephrosis: This condition can occur in infants, especially after birth, due to the transition from fetal to adult circulation and the maturation of the renal and urinary systems.
- Ureteropelvic junction (UPJ) obstruction: Although less common, UPJ obstruction can cause minimal central pelviectasis in infants. This condition occurs when there is a blockage at the junction of the ureter and renal pelvis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Posterior urethral valves (PUV): PUV is a life-threatening condition that can cause obstructive uropathy, leading to renal failure if left untreated. Although rare, it is essential to consider PUV in the differential diagnosis, especially in male infants.
- Urethral atresia or stenosis: These conditions can cause obstructive uropathy and renal failure if not promptly diagnosed and treated.
- Rare diagnoses
- Megacalycosis: A rare congenital anomaly characterized by the dilation of the renal calyces, which can cause minimal central pelviectasis.
- Multicystic dysplastic kidney (MCDK): Although MCDK typically presents with multiple cysts and a non-functional kidney, it can occasionally cause minimal central pelviectasis in infants.
- Congenital mesoblastic nephroma: A rare congenital tumor that can cause obstructive uropathy and renal impairment, although it is typically associated with more significant renal abnormalities.