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Horseshoe Kidney
Alessandro Furlan, MD; Mark D. Sugi, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Congenital anomaly in which kidneys are fused by isthmus at pole of each kidney, almost always at lower poles (90%)
              • 3 anatomic anomalies: Ectopia, malrotation, and aberrant vascular supply

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • Ultrasonographic Findings

                    • Angiographic Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        • Renal Transplantation

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Sevmis M et al: Two renal transplants from living donors with horseshoe kidneys. Urology. 144:230-3, 2020
                                              2. Sachsamanis G et al: Management and therapeutic options for abdominal aortic aneurysm coexistent with horseshoe kidney. J Vasc Surg. 69(4):1257-67, 2019
                                              3. Raman A et al: Robotic-assisted laparoscopic partial nephrectomy in a horseshoe kidney. A Case Report and Review of the Literature. Urology. 114:e3-5, 2018
                                              4. Huang J et al: Percutaneous cryoablation of the horseshoe kidney: an initial experience. J Vasc Interv Radiol. 28(4):498-501, 2017
                                              5. Nwoke F et al: May-Thurner syndrome and horseshoe kidney. J Vasc Interv Radiol. 27(3):369, 2016
                                              6. Sakala MD et al: The horseshoe kidney. Abdom Imaging. 40(7):2910-1, 2015
                                              7. Natsis K et al: Horseshoe kidney: a review of anatomy and pathology. Surg Radiol Anat. 36(6):517-26, 2014
                                              8. Majidpour HS et al: Percutaneous management of urinary calculi in horseshoe kidneys. Urol J. 5(3):188-91, 2008
                                              9. O'Brien J et al: Imaging of horseshoe kidneys and their complications. J Med Imaging Radiat Oncol. 52(3):216-26, 2008
                                              10. Cho JY et al: Prenatal diagnosis of horseshoe kidney by measurement of the renal pelvic angle. Ultrasound Obstet Gynecol. 25(6):554-8, 2005
                                              11. Strauss S et al: Sonographic features of horseshoe kidney: review of 34 patients. J Ultrasound Med. 19(1):27-31, 2000
                                              12. Krishnan B et al: Horseshoe kidney is associated with an increased relative risk of primary renal carcinoid tumor. J Urol. 157(6):2059-66, 1997
                                              13. Pozniak MA et al: Three-dimensional computed tomographic angiography of a horseshoe kidney with ureteropelvic junction obstruction. Urology. 49(2):267-8, 1997
                                              14. Banerjee B et al: Ultrasound diagnosis of horseshoe kidney. Br J Radiol. 64(766):898-900, 1991
                                              15. Mesrobian HG et al: Wilms tumor in horseshoe kidneys: a report from the National Wilms Tumor Study. J Urol. 133(6):1002-3, 1985
                                              16. Evans WP et al: Horseshoe kidney and urolithiasis. J Urol. 125(5):620-1, 1981
                                              17. Boatman DL et al: Congenital anomalies associated with horseshoe kidney. J Urol. 107(2):205-7, 1972
                                              18. Kolln CP et al: Horseshoe kidney: a review of 105 patients. J Urol. 107(2):203-4, 1972
                                              19. Eisendrath DN et al: Horseshoe kidney. Ann Surg. 82(5):735-64, 1925
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Definitions

                                                          • Congenital anomaly in which kidneys are fused by isthmus at pole of each kidney, almost always at lower poles (90%)
                                                          • 3 anatomic anomalies: Ectopia, malrotation, and aberrant vascular supply

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • Ultrasonographic Findings

                                                                • Angiographic Findings

                                                                  • Nuclear Medicine Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Gross Pathologic & Surgical Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    • Renal Transplantation

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Sevmis M et al: Two renal transplants from living donors with horseshoe kidneys. Urology. 144:230-3, 2020
                                                                                          2. Sachsamanis G et al: Management and therapeutic options for abdominal aortic aneurysm coexistent with horseshoe kidney. J Vasc Surg. 69(4):1257-67, 2019
                                                                                          3. Raman A et al: Robotic-assisted laparoscopic partial nephrectomy in a horseshoe kidney. A Case Report and Review of the Literature. Urology. 114:e3-5, 2018
                                                                                          4. Huang J et al: Percutaneous cryoablation of the horseshoe kidney: an initial experience. J Vasc Interv Radiol. 28(4):498-501, 2017
                                                                                          5. Nwoke F et al: May-Thurner syndrome and horseshoe kidney. J Vasc Interv Radiol. 27(3):369, 2016
                                                                                          6. Sakala MD et al: The horseshoe kidney. Abdom Imaging. 40(7):2910-1, 2015
                                                                                          7. Natsis K et al: Horseshoe kidney: a review of anatomy and pathology. Surg Radiol Anat. 36(6):517-26, 2014
                                                                                          8. Majidpour HS et al: Percutaneous management of urinary calculi in horseshoe kidneys. Urol J. 5(3):188-91, 2008
                                                                                          9. O'Brien J et al: Imaging of horseshoe kidneys and their complications. J Med Imaging Radiat Oncol. 52(3):216-26, 2008
                                                                                          10. Cho JY et al: Prenatal diagnosis of horseshoe kidney by measurement of the renal pelvic angle. Ultrasound Obstet Gynecol. 25(6):554-8, 2005
                                                                                          11. Strauss S et al: Sonographic features of horseshoe kidney: review of 34 patients. J Ultrasound Med. 19(1):27-31, 2000
                                                                                          12. Krishnan B et al: Horseshoe kidney is associated with an increased relative risk of primary renal carcinoid tumor. J Urol. 157(6):2059-66, 1997
                                                                                          13. Pozniak MA et al: Three-dimensional computed tomographic angiography of a horseshoe kidney with ureteropelvic junction obstruction. Urology. 49(2):267-8, 1997
                                                                                          14. Banerjee B et al: Ultrasound diagnosis of horseshoe kidney. Br J Radiol. 64(766):898-900, 1991
                                                                                          15. Mesrobian HG et al: Wilms tumor in horseshoe kidneys: a report from the National Wilms Tumor Study. J Urol. 133(6):1002-3, 1985
                                                                                          16. Evans WP et al: Horseshoe kidney and urolithiasis. J Urol. 125(5):620-1, 1981
                                                                                          17. Boatman DL et al: Congenital anomalies associated with horseshoe kidney. J Urol. 107(2):205-7, 1972
                                                                                          18. Kolln CP et al: Horseshoe kidney: a review of 105 patients. J Urol. 107(2):203-4, 1972
                                                                                          19. Eisendrath DN et al: Horseshoe kidney. Ann Surg. 82(5):735-64, 1925