A 45-year-old female patient with hyperparathyroidism receives an X-ray. What is your diagnosis?

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 A 45-year-old female patient presents with elevated calcium levels due to hyperparathyroidism.

Multiple bilateral calcifications are seen in the medullary regions of both kidneys. Note the typical configuration of pyramids which is equivalent to echogenic pyramids by ultrasound.

Nephrocalcinosis was at times referred to as Albright calcinosis or Anderson-Carr kidney. In this process, there is deposition of calcium salts in the parenchyma of kidneys in various locations. A majority of the types of nephrocalcinosis is in a medullary distribution followed by cortical distribution. 

However, calcinosis can occur in a mixed distribution involving both the medullary and cortical regions. Hyperparathyroidism, medullary sponge kidney and renal tubular acidosis are common causes for such a type of nephrocalcinosis.

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Image IQ Quiz: Patient Presents with Hyperparathyroidism