SUMMARY OF THE CLINICAL HISTORY

This is a 32 years old woman presenting with chronic right lumbar pain and 5 episodes of acute pyelonephritis for the last 10 years, and one episode of macroscopic hematuria. Physical examination: BP 110/60 mmHg, BMI: 16.9, the remaining was normal. Laboratory work-up: normal renal function, no proteinuria or hematuria.  Normal renal ultrasound. Intravenous urography: mild dilation of the right renal pelvis, which is slightly descended (Fig. 1a and 1b). Decubitus diuretic renogram (DTPA-Tc99m/furosemide): good bilateral kidney perfusion and normal excretion curves. Standing-up diuretic renogram: pathological descent of the right kidney with compromised perfusion and mild pyelic ectasis (Fig. 2a and 2b). Diagnosis: right renal ptosis.