What causes faceless kidney sign in fetal kidney on ultrasound?
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Answer:
faceless kidney sign: Absence of normal renal sinus fat and calyces contour in transverse fetal kidney section, resulting from severe hydronephrosis distorting pelvicalyceal structures or duplication anomaly where imaging plane passes through parenchyma between duplicated collecting systems, preventing misdiagnosis of renal mass.
Why is it called so?:
Named for the homogeneous parenchymal appearance lacking central renal sinus fat, pelvis, and calyces, resembling a “faceless” structure without characteristic central features.
Pathophysiology:
In severe hydronephrosis, marked dilatation obliterates sinus fat and distorts calyceal contours; in duplication anomaly, transverse section at mid-pole or moiety junction captures only cortex and medulla without vascular or collecting system elements, creating uniform echogenic parenchyma devoid of sinus signature.
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