Saturday, March 27, 2010

Large renal calculus

Stones or calculi as they are known in medical parlance are present in both kidneys (see ultrasound images above). The right kidney shows particularly large stones filling the collecting system in the upper and lower halves ie: the renal calyces. An Xray would help determine (for academics) if these calculi in the right kidney form what is called a staghorn calculus..a single large stone that fills up the entire kidney. Staghorn or not, this patient needs urgent medical attention, maybe surgery would be the better option.
See: for more on this topic.

Friday, March 26, 2010

TRUS (transrectal ultrasound) of prostate utricle cyst:

Transabdominal ultrasound image of prostate:

Male patient of dysuria, middle aged. Ultrasound image via the abdominal route shows a suspicious lesion in the prostate. This lesion must be reasonably large to be seen on transabdominal imaging of the prostate.

TRUS image of the prostate:

The TRUS image on the left is a coronal-transverse section of the prostate. On sagittal section through the same organ, the cyst is seen well, midline and measuring almost 11 mm. Such cysts can often be troublesome for the patient though in others similar lesions can be asymptomatic.
for more images of the prostate.
Here is an ultrasound video clip of a similar case:
The arrow points to the prostatic utricle cyst, as seen in this oblique coronal section, as the probe pans from the upper part (base) to the lower tip (apex) of the prostate.

Sunday, March 21, 2010

Tendon problems- the biceps and achilles tendons

The Achilles is the largest and most powerful tendon in the human body. But like the name suggests, it is the proverbial Achilles heel during extreme physical stress. Sudden or unusual exercise or physical activity can cause the rupture of the Achilles tendon. The ultrasound image above shows a full thickness tear through this tendon located just above the heel.
for more.

The biceps tendon is the cord that connects the biceps muscle in the forearm to its insertion in the humerus. Chronic wear and tear with inflammation can cause biceps tendonitis. Ultrasound is now increasingly being used as a cheaper and better alternative to MR imaging in studying tendon pathology. See:
for extensive discussion on this topic.
Both ultrasound images are courtesy of Shlomo Gobi, Israel.

Wednesday, March 17, 2010

TRUS imaging- some helpful hints

TRUS or transrectal ultrasound imaging is increasingly being used to investigate male infertility. The sonographic imaging of the prostate, vas deferens, seminal vesicles and ejaculatory ducts using TRUS is crucial in determing pathology of these parts of the male genito-urinary system. But often, the insertion of the endocavitary probe or Transrectal probe, causes considerable pain and hence non co-operation from the patient.
I have found this technique to be useful in almost all cases:
Ask the patient to breath in and out (deeply inspire and expire), and insert the transducer very slowly with each breath.
Another method: ask the patient to strain as though trying to defecate; this causes the anal sphincters to open and makes probe insertion easy.
Visit :

Friday, March 12, 2010

Internal jugular vein phlebectasia:

The internal jugular vein in this Color Doppler image shows mild dilatation in its proximal part.
The transverse section shows marked turbulence in this vein, which is unusual, and suggests some intrinsic pathology which in this case is the large diameter of the vein. Note that the vein is far greater in size than the Common carotid artery near it. You can read more on this topic by scrolling down to the case and images at:

Sunday, March 07, 2010

Another Color Doppler video of the ductus venosus

Another example of the normal ductus venosus. Demonstrating the short vessel (arrow heads) connecting the Umbilical vein to the inferior vena cava via the hepatic vein.

This Duplex doppler image shows the typical 3 waves of the spectral trace of the normal Ductus.
For more details visit:

The elusive fetal ductus venosus

This short Color Doppler video clip shows marked aliasing in the ductus venosus (arrow heads).
The still image below shows the spectral waveform so typical of the ductus in Duplex Doppler.