Robert L. Lebowitz, M.D. Children' s Hospital, Harvard Medical School Boston, Massachusetts

Prenatal diagnosis of hydronephrosis. Ultrasound showed right upper pole hydrophrenosis (figure 1) and a ureterocele on the right side of the bladder. (figure 2) Ultrasound also showed changing left lower pole hydrophrosis (figure 3) A VCUG showed the right ureterocele (figure 4) bilateral grade 3 lower pole reflux (figure 5) It was not possible to tell, from the appearance of the lower pole pelvicalyceal systems, which side had upper pole hydronephrosis. A DMSA scan (not shown) shows no uptake in the right upper pole.