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CT scan of kidney shows white dots. Could it be phleboliths or stones?

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Practicing since : 2005
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I am sending 4 CT scan pictures to YYYY@YYYY , from a CT scan I paid for privately.
I hadn’t drunk anything for at least 3 hours before (due to travelling) and I had emptied my bladder (there were no instructions about having a full bladder).

My right kidney is lower than usual.

Pictures 1 and 2 were before contrast XXXXXX was inserted.
Pictures 3 & 4 were post contrast.
I can send more pictures if needed.

The question I would like to ask please is:-
Do you think the white dots in pictures 1 & 2 are phleboliths or stones?

Thank you.
Posted Mon, 15 Oct 2012 in X-ray, Lab tests and Scans
Answered by Dr. Ranjeet Jagdale 9 hours later

Thanks for the query.

I was able to view the scan films sent.

Right kidney is normally slightly lower than left kidney, on account of asymmetry caused by liver on right side. Does your report mention liver to be of normal size? Because if that is enlarged then you can also have kidney being pushed down.

About those two white dots in pelvis, they look like surgical clips if you have undergone a tubal ligation surgery in the past. They are unlikely to be ureteric calculi as there is no obstruction to both the kidneys.
It would be better if you could send me coronal image with contrast filling the ureters.

What I am not happy is the things which are projecting into your urinary bladder; but I cannot comment more about them with these fewer images.

Please post other images for further comments.

Above answer was peer-reviewed by
Follow-up: CT scan of kidney shows white dots. Could it be phleboliths or stones? 20 hours later
Hello Dr Jagdale,

Thank you for replying.

The report didn't mention anything about my liver being enlarged. My right kidney is below my waist, towards the front of my body. From what I have read on the internet, I was wondering whether its position could be because it didn't travel all the way up before I was born. My mother was ill with kidney problems while she was pregnant with me and needed an emergency operation 6 months after I was born - the doctors wanted to do it sooner but she kept refusing. She remembers her left kidney being described as having "two heads and one body". She had part of her left kidney removed as it was badly infected. We have not been able to find out what her medical diagnosis was.

I have never had tubal ligation surgery.
Could the white dots be something other than phleboliths or stones?

I am sending you the three coronal images with contrast. On image 2 / 3 it looks to me like the contrast stops soon after leaving my kidney. On the left side the contrast can be traced all the way down in the transverse sections (a little white circle) but this doesn't seem to be the case on my left side. I am sending some images.

I am also sending more images of my bladder.

I am also worried that there is a white patch above my waist on my left side and I am sending a coronal and transverse image, without XXXXXX There was no mention of this in the scan report.

I forgot to mention in my last e-mail that my father died from leiomyosarcoma (diagnosed about aged 60, died aged 68), my paternal aunt died from ovarian cancer (in her 70s), one maternal aunt had breast cancer aged about 40, this was treated but returned, with liver cancer and she died aged 60, another maternal aunt has been diagnosed with breast cancer, in her 70s). I don’t know whether this information is relevant.

Thank you for your help,

Answered by Dr. Ranjeet Jagdale 5 hours later

Thanks for the detailed family history.

Yeah the kidneys normally develop in pelvis and then ascend up to their normal position. It is infact very common to have problem in the ascent of kidneys and then they lie in the so called ectopic location. But in your case though the kidney is low placed and more anterior there is absolutely no need to worry. The only problem for such kidneys is they are more prone for injury in case you have a trauma to the abdomen. Other than that your right kidney has normal morphology and contrast enhancement pattern, so need not worry about it.

Since you never had tubal ligation, they are more likely to be phleboliths (though it would have been better if you had sent me coronal images with contrast in the ureters; the once which you have sent are reformatted ones and it’s difficult to appreciate there relationship with ureters). However based on what I see, they are less likely to be calculi (as your both kidneys and upper ureters are normal, they would have been dilated in cases of ureteric calculi).

The probable explanation for why the right ureter is not seen in entire length is that while acquiring a scan there was no contrast filled urine in that segment and it is a very common occurrence.

You have not sent me images of your contrast filled bladder (try to send me the delayed images which are usually acquired as last phase in the scanning).

I am not sure about the white patch you are mentioning above your waist. If you meant on the skin surface then I am sorry, we cannot comment about it on CT scan. However if you are seeing something on the scan image then don't worry nothing abnormal is seen in that region in the images provided.

Hope this clarifies your doubts. Let me know if you have other concerns.

Above answer was peer-reviewed by
Follow-up: CT scan of kidney shows white dots. Could it be phleboliths or stones? 1 hour later

Thank you very much for your clear and detailed explanation about my kidney - you have reassured me.

I sent the images of my contrast filled bladder and the white patch above my waist in another e-mail but I suspect it may not have reached you. I will forward it to you again.

I do appreciate you taking the time to look at the images and responding to me.

Answered by Dr. Ranjeet Jagdale 5 hours later
You are welcome XXXXXX. I am happy to help you.

The white patch is nothing but something in your stomach - probably something that you might have eaten; so nothing to worry about it.

The one thing I am not happy about is, something projecting into the bladder. It might be because your bladder is not full enough, though if you wish you can send me only the images of bladder in sagittal plane. If you do not have those images, you can get a pelvic ultrasonography done especially if you have any complaints related to your bladder or any pain in pelvis.

Hope this helps.

Above answer was peer-reviewed by
Follow-up: CT scan of kidney shows white dots. Could it be phleboliths or stones? 2 hours later
Thank you for reassuring me about the white patch in my stomach.

I only have one image in the sagittal plane - I will send it to you.

I am woken every night, after 3.5 - 4 hours sleep, with severe pain in my lower abdomen. I pass very little urine. The pain gradually subsides after 2 - 3 hours, during which time I pass considerably more fluid than I drink. I usually go back to sleep then and once again I am woken with the same pain after about 3 hours.
I can sleep for 3 - 4 hours sitting in an armchair and do not get this pain; it seems to be something to do with lying down. Sometimes the pain eventually goes away during the day, sometimes it stays all day but I only feel it when I move, sometimes I have a dull pain on my right just beow my waist. The longer I sleep for, the worse the pain is. My GP prescribed tablets to help me to sleep and others to block the signal from my bladder to my brain. Both made me sleep longer but the pain was worse when I woke.

Recently I have also been getting bad pain in my lower back.

Thank you very much for your help.


Answered by Dr. Ranjeet Jagdale 11 minutes later
Hello the sagittal image which you have sent is of no use for interpretation, never mind.
Anyways what did your reporting radiologist mention in his report? What does your CT scan report say?
If according to the report pelvic organs are normal then dont worry as he would have all the images to look at before giving his opinion and I just had few images to comment uopon

What I would suggest is you should get a pelvic USG done on full bladder if your report does not mention anything about the pelvis.

Let me know after the scan report.
Above answer was peer-reviewed by
Follow-up: CT scan of kidney shows white dots. Could it be phleboliths or stones? 2 days later

Thank you for your reply. I am sorry it has taken me a while to respond.

The CT report I received was as follows:-
“Normal kidneys which are of good size at 11.2 cm length right and 11.5 cm left with no renal calculi and no hydronephrosis. Free drainage of contrast of ureters of normal calibre to the bladder with no ureteric calculi (phleboliths in pelvis). Incidental finding of circumaortic left renal venus collar as normal variant.

The liver is essentially normal as are the pancreas and spleen. Normal calibre aorta. No free fluid or collection. Degenerative changes in the lower lumbar spine are not particularly unusual for age.

Summary – Negative CT study.”

I asked my GP about the possibility of an ultrasound and she said it isn’t necessary as the one I had a year ago showed no problems and the CT report above made no mention of any issues with my bladder. She didn’t approve of me seeking advice on the internet. I didn’t give any details of which site I had used or who I had spoken to, except that I believed it to be a reputable site with very good patient feedback.

I had already asked whether a radiologist at my local NHS hospital could give me a second opinion on the scan but I had heard nothing. My GP followed this up and was told that the radiology department would not look at a scan that had already been reported by a private radiographer.

My GP said she wanted to refer me to a psychiatrist because she feels I need to accept the original CT report. I agreed to the referral as I felt I had no choice.

She has also referred me to a private radiologist who is prepared to look at the scan with me and explain it to me. I am glad she is arranging this and happy to pay for the appointment as the radiologist will be able to see the projection into my bladder which you have noted.

I am very glad that I have used Healthcare Magic and that you have answered my questions in such a clear and understandable way. You have provided me with a lot of reassurance. You have also helped me to feel confident to ask about the projection into my bladder.

I’d like to say a very big thank you for all your help. I will let you know the outcome of the appointment with the private radiologist but it may be several weeks before I see her. I will also write a positive review on Healthcare Magic about your assistance.

Many, many thanks,


Answered by Dr. Ranjeet Jagdale 10 hours later
Hello XXXXXX, am glad that I could be of help to you.

Yeah it is a good idea to get the doubts cleared.

The report sounds fine and fact that your USG was normal a year back than most likely that something which is projecting into your bladder will be mostly the way CT section has gone through your bladder and would probably be nothing.

Anyway good luck and it would be great,if you would let me know what other radiologist has to say about it.

Thank you and take care.
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