Learning Objectives:
Describe the indications and limitations of US of the kidneys and bladder
Perform US to evaluate the urinary tract
Identify relevant US anatomy including the renal cortex, renal pelvis, ureter, bladder, liver, spleen, and uterus or prostate
Recognize the relevant findings and pitfalls when evaluating for hydronephrosis, renal calculi, renal masses, bladder volume, pregnancy, and Foley catheter evaluation
Indications:
Flank pain
Back pain
Abdominal pain
Hematuria
Acute Urinary Retention
Acute Renal Failure/Acute Kidney Injury
Extended Indications:
Infection/abscess of the kidney
Gross bladder/prostate abnormalities
Foley cather placement/confirmation/evaluation
Required Views:
R/L kidney in transverse
R/L kidney in sagittal
Bladder in transverse
Bladder in sagittal
Post void residual if applicable
ANATOMY:
How to Scan:
Five Minute Sono: Aortic Dissection
Five Minute Sono: Aortic Aneurysm
POCUS 101: Aorta Ultrasound Made Easy
Tips/Tricks/Pitfalls:
A small aortic diameter DOES NOT rule out rupture. Always combine the clinical picture with your US findings.
The aorta can be confused for the IVC. Make sure that you identify the bifurcation and branching vessels.
There can be clot in the aortic wall which can make the diameter appear falsely small. Be careful to make sure that you are measuring the true outer wall to outer wall.
Pathology:
Abdominal Aortic Aneurysm (AAA)
Aortic Dissection
Aorta with intramural thrombus
AAA with graft and endoleak
Indirect signs of Thoracic Aortic Aneurysm
Pericardial Effusion
Dilated aortic root
Key Literature:
Additional Resources:
Author: Niyi Soetan, MD
Peer editing by: Kyle Ackerman, MD