The “bouquet of flowers” appearance in medullary sponge kidney

The “bouquet of flowers” appearance is a radiological finding described for the intravenous pyelography (IVP) diagnosis of medullary sponge kidney (MSK). It refers to contrast pooling in dilated tubular structures in renal papillae, giving a striated pattern to the renal medulla, which resembles a “bouquet of flowers”