Incidental horseshoe kidney
Recommended: CT or MRI Abdomen is the preferred imaging study for incidental horseshoe kidney. Most common renal fusion anomaly.
Recommended study
CT or MRI Abdomen
Most common renal fusion anomaly. Lower-pole fusion typical; isthmus crosses midline anterior to aorta.
If the default doesn't apply
Vascular anatomy for surgical planning
CT
CTA Abdomen
IV contrast
Watch-outs
Increased risk of complications
Higher rates of stones, UPJ obstruction, vesicoureteral reflux, and certain cancers (Wilms, RCC, urothelial).
Multiple renal arteries
Variable arterial anatomy — image vessels before any percutaneous intervention.
Pearls
- Isthmus tethered below IMA, preventing normal cranial ascent.
- Increased risk of injury in blunt abdominal trauma (anterior position).
- Higher Wilms tumor risk in children — surveillance considered.