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Urogenital Imaging

Nephroptosis

(also called renal ptosis, or floating kidney), an abnormal caudal movement of the kidney when the patient changes from the supine to erect position. The excessive mobility may be attributed to the deficiency of supporting perirenal fasciae. It differs from congenital ectopia in which the kidney has not ascended to its normal position. In ptosis, the ureter is of normal length, becoming kinked when the patient is erect, whereas in congenital ectopia the ureter is short. The kinking of the ureter near the ureteropelvic junction in the erect position has historically been cited as a cause of obstruction, but this is currently believed by most authorities to reflect misdiagnosis of ureteropelvic junction obstruction as nephroptosis (see Dietls crisis. Nephroprexy was performed in the past to stabilize the kidney. Presently surgery is not recommended. In fact some consider up to a 10 cm descent of the kidney in the erect position as normal. Diagnosis can be made during intravenous urography, by obtaining erect films.

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