Published in:
01-12-2014 | Classics in Abdominal Imaging
The golf ball-on-tee sign
Published in: Abdominal Radiology | Issue 6/2014
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The fanciful metaphor “golf ball-on-tee” (Fig. 1) describes imaging findings that signify renal papillary necrosis [1, 2]. Once opacified with contrast material, the central calyceal cavity (the “golf ball”) appears to rest on the calyx (the “tee”). While this sign originally was described at excretory urography, the findings are now most often seen on CT (Fig. 2A, B) [3]. Other “classic” imaging patterns of papillary excavation seen in papillary necrosis include the “lobster claw” and “signet ring” appearance (Fig. 3).
Fig. 1
A golf ball-on-tee (picture courtesy of Richard T. Dyer).
Fig. 2
A Axial CT image during excretory phase imaging shows a large lower pole papillary cavity in the left kidney with the golf ball-on-tee appearance (arrow). B Coronally reconstructed image during the excretory phase in the same patient shows the classic “golf ball-on-tee” appearance in multiple calyces (arrows).
Fig. 3
Patterns of papillary excavation seen in papillary necrosis including “golf ball-on-tee” (B), “lobster claw” (D), and “signet ring” (E) appearances (figure used with permission from Ref. [1]). Normal calyx (A), forniceal excavation (C) and clubbed calyx appearance with sloughing of the papillary tip (F).
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