<s>[INST] Ultra Sound Findings: There is increased echogenicity around the renal pyramids bilaterally which can be seen with nephrocalcinosis and a CT KUB is recommended. No hydronephrosis. There are two echogenic lessions within the left kidney with shadowing. Likely to represent calculi. What does this mean [/INST] Hi,Thanks for writing in.There is a possibility of small stones forming in your kidneys on both sides. There are two small stone like areas in the left kidney. While ultrasound scan can certainly locate larger stones, some of the smaller stones need detailed evaluation in the presence of symptoms. A CT scan is sensitive to pick up stones measuring 2 mm in diameter which can be missed by ultrasound. Increased echogenicity around kidney pyramids might indicate small stone formation in progress. For complete assessment of kidney stones, a CT scan is to be done. Please continue drinking adequate amounts of water to flush out smaller stones. </s>