What causes Putty kidney in the kidney on plain radiography?
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Answer:
Putty kidney represents extensive parenchymal calcification forming a cast of a small, scarred, non-functioning kidney in end-stage renal tuberculosis, also known as autonephrectomy, resulting from hematogenous seeding of Mycobacterium tuberculosis leading to granulomatous inflammation, caseous necrosis, cavitation, fibrosis, stricture formation, obstruction, atrophy, and dystrophic calcification.
Why is it called so?:
The term “putty kidney” describes the radiographic appearance of dense, amorphous, lobulated calcifications in the renal region resembling the soft, moldable consistency of putty, first coined in 1906 by genitourinary surgeon Dr. F. Tilden Brown.
Pathophysiology:
Hematogenous dissemination of Mycobacterium tuberculosis seeds the glomerular and peritubular capillaries, inducing granuloma formation with caseous necrosis and cavitation in the renal parenchyma; progressive fibrosis, calyceal strictures, and obstruction cause hydronephrosis, parenchymal atrophy, and shrinkage, followed by dystrophic calcification within necrotic debris that outlines the original renal contour.
Alternative names: Autonephrectomy sign
Other associated named signs: None
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