{"id":5490,"date":"2011-07-14T20:26:55","date_gmt":"2011-07-14T20:26:55","guid":{"rendered":"http:\/\/crashtext.org\/misc\/renal.htm\/"},"modified":"2011-10-30T20:36:17","modified_gmt":"2011-10-31T00:36:17","slug":"renal","status":"publish","type":"post","link":"https:\/\/crashingpatient.com\/ultrasound\/renal.htm\/","title":{"rendered":"Renal"},"content":{"rendered":"
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Renal<\/p>\n
Indications<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Colic<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Urinary Retention<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Pyelonephritis<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Question of Mass<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Trauma<\/p>\n
Anatomy<\/p>\n
R kidney is usually larger and lower than the left<\/p>\n
Inferior poles are anterior and lateral to the superior poles<\/p>\n
Technique<\/p>\n
3.5 MHz unless thin<\/p>\n
Right Kidney<\/p>\n
Scan in sag at mid-clavicular line or coronal at mid ax (Point Marker towards post-ax). Start at costal margin and move down.<\/p>\n
Left Kidney<\/p>\n
Mid ax line.\u00a0 May need to go up on ribs.\u00a0 Scan may be aided by placing patient in right lateral recumbent<\/p>\n
Findings<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 R sided hydro during pregnancy is common and not pathologic<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Pyelo appears as normal kidney until abscess which appears as a round, hypoechoic mass<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Absence of ureteral jets by Doppler is 100% sensitive for obstruction<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hydro can be masked by dehydration, and simulated by a full bladder.\u00a0 Give IV fluids before scanning<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Normal renal parenchyma is less echogenic than the liver<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Obstructive Uropathy<\/p>\n
Hydronephrosis appears as echo-free areas in the sinus.\u00a0 Bladder volume can be measured with built-in calculators, but estimation is usually sufficient.<\/p>\n
Variants<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sonolucent pyramids-looks like hydro, but in the medulla, not the sinuses<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Duplication of collecting system-split in the sinus<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ectopic Kidney<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Prostate Enlargement<\/p>\n
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