Uncategorized Voiding Cystourethrogram ? Posterior Urethral Valves – Keyhole Sign5-year-old boy who was noted to have hydronephrosis on ultrasound. VCUG in the RAO oblique-lateral view shows dilated proximal urethra caused by posterior urethral valves, with secondary bladder outlet obstruction. The resulting shapes are reminiscent of a keyhole ? and hence the ?keyhole sign?. Distal to the obstruction the penile urethra assumes a normal caliberAshley Davidoff MD TheCommonVein.net 135754c