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We invite you to join our upcoming online case discussion, featuring a puzzling renal presentation of a 49-year-old woman with recurrent urinary tract infections and untreated nephrolithiasis, who presented with a two-week history of worsening right flank pain, nocturia, nausea, and anorexia. Imaging revealed striking distorted architecture, hypoechoic foci, and a striking “bear paw” pattern, possibly resulting from overlapping infectious, obstructive, and inflammatory processes.

This “X Factor” case challenges conventional thinking and offers a chance to refine your diagnostic skills, integrate clinical and imaging findings, and debate optimal management for a destructive kidney condition that often hides behind more familiar diagnoses. Bring your hypotheses and curiosity for an engaging, interactive session.