What Are These Bulging Bilateral Flank Masses?
This What's Your Diagnosis? column was published originally in the September 1990 issue of Consultant.
Read the Editorial based on this article, written by Consultant Board Member James Matera, DO, FACOI, here.
Henry Schneiderman, MD — Series Editor
Schneiderman H. Bilateral flank masses due to adult poly cystic kidney disease. Consultant. 1990;30:43-44.
A 55-year-old man with long-standing renal insufficiency. Has been on hemodialysis for 5 years. Father also had significant renal failure.
Bulging bilateral flank masses.
ANSWER: Adult Polycystic Kidney Disease
The kidney can be directly palpated in only a few patients, although when a person is thin or the organ is anteriorly placed or ptotic, it may be palpable in the absence of disease.1,2 Fortunately, blood pressure, the ocular fundi, and simple studies of the urine and blood permit successful inference about renal function and disorders. At times, flank palpation provides useful positive data as well as the more usual negatives.
- Sapira JD. The Art and Science of Bedside Diagnosis. Baltimore, Md: Urban & Schwarzenberg; 1990;387.
- Walzer N, Koenigsberg M. Examining the anterior right kidney: frequent lack of appreciation in examination of the right upper quadrant. JAMA. 1979;242:2320-2321.
- Avery ME, MandeII J, Simmons C, Harmon W, First LR. Approach to renal masses. In: Avery MR, First LR, eds. Pediatric Medicine. Baltimore, Md: Williams & Wilkins; 1989:614-621.
- Robson JS, Lambie AT, MacDonald MK, Newsam JE. Diseases of the kidneys and urinary tract. In: Passmore R, Robson JS, eds. A Companion to Medical Studies, vol 3. Boston, Mass: Blackwell Scientific Publications; 1974:3.22.73-3.22.75.