This ultrasound performed by R3 Family Medicine Resident Dr. DM of HSN demonstrates SEVERE hydronephrosis. This patient came through clinic and had minimal to no pain suggesting this was likely a chronic process. When estimating the degree of hydronephrosis, a general estimate based on the appearance of the renal pelvis is sufficient – there is no such thing as “40% hydronephrosis” or other exact numbers. A patient can have “mild” or “moderate” or “mild to moderate” or in the case of our patient, “severe” hydronephrosis.