Question

A female patient presented with recurrent Urinary tract infections. Imaging shows the following picture. What can be the most probable diagnosis?

• A. Duplication of Ureter
• B. Congenital Megaureter
• C. Ureterocele
• D. Urinary Stones

Answer 1

The Correct Option is C

An understanding of the anatomy and typical presentations of various urinary tract anomalies is crucial for determining the correct diagnosis. In this case, we have a female patient with recurrent urinary tract infections (UTIs) and imaging findings that likely show a characteristic pattern.

The options given are:

• Duplication of Ureter
• Congenital Megaureter
• Ureterocele
• Urinary Stones

To make an accurate diagnosis, let's consider each possibility:

1. Duplication of Ureter: This condition involves the presence of two ureters on a single kidney. It can lead to recurrent UTIs, but the imaging typically shows duplication of ureters without specific lesions like a "cobra head" sign.
2. Congenital Megaureter: This represents a dilated ureter usually diagnosed in childhood. While it can cause infections, imaging shows diffuse ureteral dilation rather than specific focal distentions.
3. Ureterocele: A ureterocele is a cystic dilation of the distal ureter where it enters the bladder. The classic presentation on imaging, especially via intravenous pyelogram (IVP), is a "cobra head" or "spring onion" sign which is pathognomonic. This condition can frequently lead to UTIs as urine flow is obstructed or stagnant.
4. Urinary Stones: Presence of stones may cause recurrent UTIs, but they are typically identified as high-density structures on imaging without specific cystic dilation at the ureter's distal end.

Given the combination of recurrent UTIs and characteristic imaging appearance, the most probable diagnosis is Ureterocele, as the imaging showing the "cobra head" sign aligns with this condition.