CHAPTER 99: Various Findings

Recipient with no clinical symptoms prior to transplantation who developed edema of the head, neck, and upper torso intraoperatively. A diagnosis of superior vena cava stenosis (white arrows) was made, likely secondary to the previous insertion of multiple dialysis catheters. Given the severity of the clinically findings that did not resolve postoperatively, a surgical repair was required.

Recipient with no clinical symptoms prior to transplantation who developed edema of the head, neck, and upper torso intraoperatively. A diagnosis of superior vena cava stenosis (white arrows) was made, likely secondary to the previous insertion of multiple dialysis catheters. Given the severity of the clinically findings that did not resolve postoperatively, a surgical repair was required.

X-ray (Figure 99-3) fails to demonstrate an oblique stress fracture of the left tibia. Nuclear medicine bone scan (Figure 99-4) shows increased uptake (red arrow) compatible with a fracture. As this case illustrates, whenever pathology is suspected and the initial imaging study is negative, additional imaging studies should be obtained.

X-ray (Figure 99-3) fails to demonstrate an oblique stress fracture of the left tibia. Nuclear medicine bone scan (Figure 99-4) shows increased uptake (red arrow) compatible with a fracture. As this case illustrates, whenever pathology is suspected and the initial imaging study is negative, additional imaging studies should be obtained.

Sagittal CT scan in a 30-year-old male kidney transplant recipient showing decreased bone density in the lumbar spine, especially in the midportion of the vertebral bodies, in a “rugger jersey” appearance of secondary hyperparathyroidism. Osteopenia is a common finding and is mainly related to chronic steroid use.

A small amount of postoperative gas (white arrow) can be seen. Note also the atrophic native kidneys (blue arrows) and a right renal cyst (yellow arrow).

Sagittal T1-weighted magnetic resonance image showing epidural lipomatosis (red arrows). Fat has high signal intensity on T1-weighing. Epidural lipomatosis can sometimes be a symptomatic finding associated with the steroid therapy given to transplant patients.