Polycystic kidney disease is typically associated with which inheritance pattern and imaging feature?

• A. Autosomal dominant inheritance with multiple bilateral parenchymal cysts
• B. Autosomal recessive inheritance with single cyst
• C. X-linked recessive inheritance with no cysts
• D. Autosomal dominant with multiple unilateral cysts

Answer: (A)

Polycystic kidney disease is classically autosomal dominant and shows up on imaging as many cysts in both kidneys, making them enlarged and multicystic throughout the renal parenchyma. This bilateral, multi-cyst pattern is the hallmark of the common ADPKD form seen in adults. In contrast, the autosomal recessive form (ARPKD) usually presents in infancy with markedly enlarged echogenic kidneys and cysts mainly in the collecting ducts; a single cyst is more typical of a simple renal cyst rather than polycystic disease; and an X-linked recessive pattern with no cysts doesn’t match PKD’s imaging appearance.