Chronic kidney disease. History of left-sided hydronephrosis. Evaluate for obstruction. RIGHT KIDNEY: The right kidney measures 8.8 cm in length. The cortex is mildly echogenic. No hydronephrosis, shadowing nephrolithiasis or discrete lesion.LEFT KIDNEY: The left kidney measures 10.1 cm in length without hydronephrosis, or shadowing nephrolithiasis. The cortex is echogenic.Note is made of a 1.4 x 1.2 x 1.3 cm hypoechoic cortical lesion without definite enhanced through transmission. Additional adjacent hypoechoic probable cyst is noted.URINARY BLADDER: Normally distended urinary bladder. The left ureteral jet is visualized indicating patency.OTHER: No significant abnormalities noted.
Echogenic mildly atrophic kidneys compatible with medical renal disease.No hydronephrosis.1.4 cm left renal lesion is hypoechoic with equivocal enhanced through-transmission, therefore is not a definite simple cyst, and remains indeterminate. Consider dedicated renal CT/MR if the patient can tolerate contrast, or follow-up with ultrasound for size change. 