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
Thin walled, Anechoic interior, Posterior acoustic enhancement