1. Diagnostic mistakes of radiology visualization of urolithiasis M. Pasichnyk, S.Pasichnyk, A. Shulyak Lviv National Medical University Lviv, Ukraine

2. Clinical presentation Age: 40 years Gender: male Complaints: Acute renal colic. History of disease: acutely admitted by ambulance to the Rivne Regional Diagnostic Center History of life: before hospitalization this patient had no complaints. Occupation: worker of the porcine farm

3. Results of clinical examination Pain in right flank, positive Merphy’s sign on the right Blood cell count: Hb 122 g/L, er 3x10 12 /L, L 6.8x10 9 /L, ESR 9 mm/h Differentional blood cell count: eosiniphilia (9%). Urinalysis: normal Blood biochemistry: normal Blood coagulation test: normal

4. Ultrasonography Right kidney: parenchima normal, hydroureteronephrosis to the upper third of ureter (its diameter 9 mm) without any stone Left kidney, liver, spleen, regional lymphatic nodes are normal.

5. KUB (lumbar region) Please note two shadows suspicious of calculus located at L I and L III-IV on the right side

6. KUB (pelvic region) Please note two shadows located in the soft tissues above the coxofemoral joint

7. Topogram of the trunk Note the multiple system ossifications in the soft tissues

8. CT of trunk There are a lot of calcificates in the muscles of back

9. CT with contrasting Note the hydroureteronephrosis on the right

10. CT of the brain Note foci of calcification in the brain

11. Conclusions of CT Multiple calcifications of the soft tissues Hydroureteronephrosis to the upper third of the ureter on the right caused by the periureteral calcification (diameter about 7 mm)

12. Management This particular patient refused from any treatment Follow-up of this case was impossible

13. What is your diagnosis? What additional tests would you prescribe? What management would you suggest?

14. Our diagnosis Cystocercosis? Treatment: specific drugs against cystocercosis according to the consultation of infectionist and ureteral stenting

15. Similar cases from the literature Typical oval calcified cysticercus in muscles of a hip (Nigeria) CT – calcified cysticercus located in a brain near the ventriculus, but in that patient not causing other changes (CT with contrasting) (Egypt)

16. What is cysticercosis ? - Similarly to other parasitic diseases, cysticercosis is caused by the use of contaminated food or water. Sometimes autoinfection of the patient already infected with a tape worm is noted. Unlike in the brain (or eyes), in the visceral organs cysticercus are surrounded by the fibrous capsule, but remain alive for several years. Holger Pettersson, MD Professor of Radiology University Hospital Lund, Sweden, 1995