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Loss of corticomedullary differentiation in the kidney is primarily caused by conditions that lead to renal ischemia, acute tubular injury, or chronic kidney disease. This can occur in scenarios such as acute kidney injury, chronic interstitial nephritis, or glomerular diseases, where the normal distinction between the renal cortex and medulla becomes blurred due to cellular damage, fibrosis, or inflammation. Imaging studies, particularly ultrasound or CT, may reveal this loss, indicating underlying pathology affecting renal function.

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Corticomedullary differentiation on medical diagnostic imaging is the visualisation of the difference of intensity (MRI) , echogenity (Ultrasound) or attenuation (CT) between the cortical and medullary tissue in an organ. For Example; The kidney has a cortex (the peripheral tissue) and a medulla (central to the cortex). On an ultrasound scan, the cortex should look whiter (more echogenic) than the medulla and thus, you should be able see and differentiate between these two different tissues judging by their color.. Loss of corticomedullary differentiation is what its called when both cortex and medulla are seen as the same shade of grey and one can not see any change of color (any change in shade of grey tones as most diagnostic images are black and white) on the border of cortex and medulla.


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