To describe a rare case of nontraumatic ureteral entrapment at the sacroiliac joint associated with degenerative changes and obstructive uropathy.
Approach:
Case: A 77-year-old woman with chronic lower back pain and no urinary symptoms underwent evaluation after ultrasonography showed mild right hydronephrosis.
Imaging: Contrast-enhanced CT intravenous pyelography showed hydroureter extending to the right sacroiliac joint, where the ureter was adherent and narrowed. The joint had advanced degenerative changes; no stone, mass, extrinsic compression, or surrounding fibrosis was…
Management: The patient was managed conservatively with urologic surveillance and periodic renal ultrasonography. She declined a recommended renal functional scan.
Key Findings:
CT findings indicated right ureteral entrapment at the sacroiliac joint, attributed to chronic degenerative sacroiliitis.
Contrast excretion from the right kidney was markedly delayed, with persistent enhancement and mild cortical thinning.
At 3 months, ultrasonography showed no significant progression of hydronephrosis.
The authors described this as the third reported nontraumatic clinical case of ureteral entrapment at the sacroiliac joint.
Interpretation:
The authors stated that ureteral entrapment at a degenerative sacroiliac joint may be considered when hydronephrosis has no identified cause, and emphasized tracing the ureter across the joint on imaging.
Limitations:
The report describes a single patient.
A renal functional scan was not completed.
Imaging follow-up was limited to 3 months, providing little evidence about long-term renal outcomes with conservative management.
Conclusion:
The patient’s obstruction was attributed to ureteral narrowing at the right sacroiliac joint rather than proximal ureteral kinking, which the authors considered a benign consequence of ureteral mobility.
