Operative gynecology : . Fig. 314, -Two Calculi in the Right Kidney. The Larger is an Unusual Shape for a Renal Calculus. canal and the pubic spines. When these anatomical points are distinct in theskiagraph, sufficient differentiation has been obtained, as a rule, to determinethe presence or absence of a calculus. The most common situation for a calculus is in the angle formed by. thelast rib and the spinal column. A light shadow with rather a definite borderin that situation should always be viewed with suspicion. Occasionally theshadow of a calculus will be found midway between the tip of t
Operative gynecology : . Fig. 314, -Two Calculi in the Right Kidney. The Larger is an Unusual Shape for a Renal Calculus. canal and the pubic spines. When these anatomical points are distinct in theskiagraph, sufficient differentiation has been obtained, as a rule, to determinethe presence or absence of a calculus. The most common situation for a calculus is in the angle formed by. thelast rib and the spinal column. A light shadow with rather a definite borderin that situation should always be viewed with suspicion. Occasionally theshadow of a calculus will be found midway between the tip of the last rib and 570 THE USE OF THE X-RAY IN DETECTING CALCULI. the crest of the ilium. In such cases the abnormal position is due to a prolapseof the kidney. Any suggestive shadow lying externally to the twelfth rib may. Fig. 315.—Date-Seed Calculus in Right Ureter just above the Ureteral Orifice. be disregarded as it is too far out to be in the kidney and is probably due tosome shadow-casting substance in the intestines. i While, theoretically, ureteral stones may be found anywhere in the ureter,practically, they rarely occur except in the lower half inch of its extent. Thepresence or absence of these stones is determined by the skiagraph of thepelvis. A line drawn from a point half an inch internal to the pubic spine URETERAL CALCULI. 571 to the sacro-iliac articulation gives roughly the position of the ureter. A lightshadow occurring in this line may be regarded as a calculus (see Fig. 315).Care must be taken, however, not to confuse such a shadow with one cast by aphlebolith. This region is richly supplied with veins and it is quite commonfor phleboliths to form in them. The shadows cast by these concretions, how-
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