This elderly male presented with severe right sided back pain.
We were asked to exclude an aortic aneurysm.
Aortic views confirmed a normal sized abdominal aorta.
The right kidney showed moderate to severe hydronephrosis with a renal calculus evident within the collecting system (however it was not the cause of obstruction in this case).
As well as this a small rim of perinephric fluid is evident surrounding the kidney and this may represent a urinoma if there has been a breach of the collecting system. It is not an infrequent finding in cases of acute ureteric obstruction.
No right sided ureteric jet was seen and CT confirmed a complete obstruction with a midureteric calculus the precipitant to his symptoms.
Back pain in the elderly should always lead one to consider aortic aneurysm.
Once this is excluded ultrasound can also help in making other diagnoses shuch as in this case with ureteric obstruction.