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Genitourinary

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Indications

Renal
  • Flank pain
  • Hydronephrosis
  • Calculi
  • Cysts
Hematuria
  • Hydronephrosis
  • Calculi
  • Cysts
Trauma
  • Free fluid
  • Abnormal appearance of kidneys
Bladder
  • Suspected bladder distension
  • Urinary retention

Acquisition

  • Enter patient’s information into machine
  • Supine position
  • Curvilinear Probe


RENAL

  • Leading edge toward head
  • Probe parallel to floor
  • Sweep from anterior axillary line to posterior axillary line
  • Rotate leading edge toward bed to angle between ribs
  • Left kidney is more cephalad and posterior than right kidney


Gerota’s fascia: hyperechoic
  • Surrounds kidney, adrenal gland & perinephric fat
Renal parenchyma
  • Cortex: hypoechoic
  • Medulla: hypoechoic with anechoic pyramids
Renal sinus:
  • Hyperechoic, anechoic calyces and renal pelvis (beginning of ureter) 






BLADDER


Transverse:

  • Leading edge toward right
  • Hand on top of probe
  • Fan caudally into true pelvis
Sagittal
  • Leading edge toward head
  • Rock probe toward leading edge (direct beam into true pelvis)

Bladder volume:
  1. Obtain transverse image
  2. Select dual screen then update
  3. Rotate leading edge toward head and center sagittal image
  4. Hit freeze
  5. Hit calculate and select volume
  6. Measure AP diameter on transverse image and save
  7. Measure width (leading edge to receding edge) on transverse image and save
  8. Measure height (leading edge to receding edge) on sagittal image and select save


Interpretation and Medical Decision Making

  • Normal
  • Hydroneprosis
  • Renal Cyst
  • Free Fluid
  • Urinary Retention
  • Bladder mass