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Urogenital Imaging

Staghorn calculus

renal stone that develops in the pelvicaliceal system, and in advanced cases has a branching configuration which resembles the antlers of a stag. Staghorn calculi are composed of magnesium ammonium phosphate (struvite), which forms in urine that has an abnormally high pH (above 7.2). This high pH usually develops because of recurrent urinary tract infection with microorganisms such as Proteus mirabilis.

Radiographically, struvite stones are of relatively low density, but may have a laminated appearance when combined with calcium salts. Low density struvite stones may not be appreciated on plain radiographs, but can be readily detected by US or CT (Fig.1). Intravenous urography or retrograde pyelography may also be used to demonstrate the typical branching appearance of staghorn calculi.

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Fig.1

Plain abdominal radiograph showing large bilateral staghorn calculi.
Staghorn calculus, Fig.1