IgA Nephropathy
Patient 1:
This is a previously healthy 78-year-old man who was admitted to the hospital with hematuria, skin rash, and abdominal pain, and ultimately diagnosed with Henoch-Schönlein purpura.
Image courtesy of “Frameworks for Internal Medicine”
Hello Dr. Mansoor, I was wondering what a renal artery bruit sounds like. Do you have some advice to make sure we can hear it properly? Thank you for your amazing work, the book and the website are very useful!
Hi Diego, great to hear from you. Renal artery bruits can be heard in two locations: anterior and posterior. Anterior bruits are typically found in a horizontal band just above the umbilicus, and will generally radiate toward the flanks. Posterior bruits are usually heard in the area between the lumbar spine and the costal margins. Anterior bruits are more sensitive than specific; posterior bruits are more specific than sensitive. The bruits have duration (like heart murmurs). They can be systolic, or sometimes extend into diastole (and some are truly continuous, meaning heard throughout all of systole and diastole). They are generally higher pitched. We don’t have a recording of a renal artery bruit that I am aware of, but we do have one of a hepatic artery. Will try to get it uploaded. And we will try to record a renal artery bruit next time we come across one. Thanks for the question !