Medullary sponge kidney (MSK) is a developmental anomaly that occurs in the medullary pyramids of the kidney. MSK is characterized by cystic dilation of the distal collecting tubules and ducts in one or more renal pyramids. Many patients remain asymptomatic, but patients with symptoms of nephrolithiasis, hematuria, and infection should be carefully evaluated for medullary sponge kidney disease. A case is presented in which sonography is used to diagnose MSK.
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