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Need translation of kidney CT

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These are some excerpts of the CT of my kidneys that I had last Friday. I need to know if hydro' means hydronephrosis of kidney, and if hte hydronephrosis refers to swelling of the kidney or of the ureter (the stone was only 2 mm on passing and measuring it), and what is punctate stone or punctate calcification. (Google isn't doing much for me on the definition of that one as all I can find is people asking in places like Yahoo Questions and getting weird adn vague answers.)

Kidneys: The right kidney is without contour abnormality or stones. There is mild right hydro' and a 3 mm stone in the distal right ureter near the bladder. The left kidney has a punctate stone in an upper pole calix. No contour abnormalities or abnormal density. There is no hydronephrosis and no stone in the left ureter.

Impression:
1. 3 mm stone in the distal right ureter, at the level of the trigone with mild hydronephrosis.
2. Punctate calcification present in a mid pole calix of the left kidney.

Also, can he tell that whatever is going on in the left kidney is calcium and not a different mineral? When calculi means kidney stone, it is not easy to discern what calcification would be.

Thanks!

Dora Smith
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replied July 13th, 2011
Extremely eHealthy
u need to discuss this in detail with your dr.s and write down your questions like u did and demand answers,
because kidney failure does not show up early so make sure u have a excellent understanding and demand that of those dr.s, do so patiently, accurately and write down their responses
.... this is not a place to get the answers
wish u the best
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replied July 16th, 2011
I got my answer, no thanks to anyone here, and least of all the doctors. It seems like most of the large numbers of people who post this question on kidney forums get no answer or smart alecky and completely nonresponsive answers like the one above, so here's the answer. Perhaps GOogle will pick it up.

Unfortunately, the term punctate has so little meaning; it is jargon, like using grapefruit to describe the size of a tumor. (In increasing numbers of countries it is illegal to use fruit or sports terms to characterize a tumor, or else doctors must use a standard table of what fruit is what size.)

It means:

Round, and that's all it means. (a radiologist where the CT scan was done) The word punctate has two synomyms, in some texts that don't define it - round and rim.
Small
Irregular (not round, rim, oval, or tiny)
Very tiny, often insignificant
Round or oval
Round and small
Round and less than 0.5 mm if and only if it's a breast calcification
Characterized by small points of calcification spread over an area, which can happen with many health problems in many organs. In the kidneys that is seen in large malignant tumors.
Medical dictionary said it means a pattern of small points or dots. How could that describe a single kidney stone? The reference librarian on duty at the medical library tried to tell me that would be a kidney stone pocked with little holes, whatever else I could possibly think it meant, and I saw someone on an online forum try the same idea!

This is a radiological term, and radiology and urology texts that use the term, as for instance to discern which findings are malignant, very rarely define it. In fact, I got a medical library reference librarian working on it, and he couldn't come up with the asnwer after looking in a great variety of very logical places. He noted some of the variety of definitions that I found.

What did the radiologist specifically mean? God knows. Man is on vacation. His photo depcits an arrogant looking man. He apparently talked to my doctor in the ER and may have spoken in English. Doctor told me I have a second, smaller stone in the left kidney. On the other hand doctor may have read radiologist's mind. There was all sorts of mind reading going on in that ER. Like nurse explaining why doctor thought I needed antibiotic; when I had a bad reaction to it same people agreed I didn't need one.

Now, I also got the CT scan. In Texas, like numerous states, the patient owns all medical records including lab results and needs only request them, sometimes for a fee. The CT scan shows a small round-looking kidney stone in my left kidney. It's probably bigger than .5 mm but hard to tell. It is smaller than the 2 mm one that I passed. (It was actually 2 mm and not 3 mm.)

If I'd asked my doctor, she'd have certainly made her own guess what the radiologist had in his mind when he wrote that. So it's a real good thing I looked into it - which it usually is. I don't know what they have this board for for the orientation against answering the question the patient asked, or necessarily even reading what he asked, around here!
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