Ultrasound imaging of Ureteral stent:

This patient underwent surgery for the removal of a staghorn calculus from the right kidney. A right ureteric stent was inserted to facilitate the smooth passage of urine in the right ureter. Ultrasound image shows the upper end of the DJ or Double J stent (JJ stent) in the right renal pelvis.















The lower end of the JJ right ureteric stent is seen in the urinary bladder as a coiled echogenic linear (tubular echo). The presence of coils/ pigtail loops at both ends pf the ureteral stent prevents its displacement or migration. Ultrasound imaging also helps to rule out other complications of ureteral stent like infection, migration, obstruction and malpositioning.
For ultrasound images/ case study of ureteral stones and ureteral pathology see:
http://www.ultrasound-images.com/ureteric-calculi.htm
For more information on ureteral stents, see:
http://radiographics.rsna.org/content/22/5/1005.full














The sonographic image above ( case-2) shows the lower end of stent in urinary bladder














Just added this image (case-2) showing the DJ stent tip (upper end) clearly in side the renal pelvis of the right kidney (view made possible due to minimal fluid/ urine in the renal pelvis)- see image just above.
For an ultrasound video of ureteral stent:
http://ultrasound-videos.blogspot.com/2010/11/double-j-ureteric-stent-ureteral-stent.html

Polycystic ovaries

A very large section of the female populace today suffers from PCO or polycystic ovaries. For them, it is a never ending story of irregular menses, hirsuitism and obesity.
For the lay person or patient this article should prove interesting:
http://www.squidoo.com/polycystic-ovaries

For the sonologist visit: http://sites.google.com/site/drjoea/ovary
for ultrasound case study of Polycystic ovary.
or http://www.ultrasound-images.com/ovaries.htm for more information on ovarian pathology, PCO etc.

A rare variant of fibroadenoma in young adolescents:

Fibroadenomas are a common entity. However, a rare occurrence is the presence of a huge mass in the breast in adolescent females. Called juvenile fibroadenomas, they are a variant of the lesion in the adult female populace. See: http://www.ultrasound-images.com/breast.htm for an ultrasound case study of this disease.
Also known as giant fibroadenoma, they are almost always benign and are not as ominous as they appear. They must be differentiated from the other large tumors of the female breast, such as the Phyllodes tumor which can turn malignant.

Early pregnancy with Nabothian cyst

Interesting case this... Transabdominal ultrasound images of suspected early pregnancy (urine pregtest positive) with pain in pelvis, showed a prominent cystic lesion at the upper border of the cervix. The cyst measured 11mm. and was located just beneath the serosa. I was not sure if this was a a cervical ectopic gestation. The lesion appeared separate from the left ovary.





























Transvaginal ultrasound images and Color Doppler imaging , revealed the presence of intrauterine gestation sac of 4.5 mm. Color Doppler image showed absence of "ring of fire" around the cyst, confirming its benign nature. The final diagnosis in this case - early gestation sac with Nabothian cyst of cervix.
See: http://www.ultrasound-images.com/early-pregnancy.htm for more such intriguing ultrasound images of early pregnancy.

 












Also visit: http://www.ultrasound-images.com/uterus.htm#Nabothian_cysts_of_the_cervix
(Discussion and images of multiple Nabothian cysts of cervix)

A sonographic picture review of renal pathology:

The ultrasound image (courtesy of Ravi Kadasne, MD) above shows a rather prominent layer of perirenal fat around the right kidney (arrows) separating the kidney from the adjacent liver. This is a normal finding, but perirenal fat may be altered by presence of hemorrhage into this layer. (See: http://radiology.rsna.org/content/149/3/665.full.pdf)
For more renal ultrasound pictures and reviews:
See this page: http://www.ultrasound-images.com/kidneys.htm It describes, with ultrasound images, many of the major pathologies that affect the human kidneys. Among the conditions that are described are normal variants like fetal lobulation and ectopic kidney/ horseshoe kidney. This is a common finding for the sonologist. Then the page shows ultrasound images of polycystic kidney disease and other non- lethal cystic diseases such as renal cortical cysts and calyceal cyst. Then there is detailed ultrasound review of renal malignancy. Renal failure is yet another lethal and very common disease that has been covered on this page.

Gallstones in neonates

Gall bladder calculi in a neonate? This ultrasound image shows just that!!. Not one stone, a gall bladder packed with calculi in a neonate!
See: http://www.ultrasound-images.com/ped-abdomen.htm (case-8)
This might sound like big bad news for a tiny baby. The good part is that gallstones in infants and neonates tend to spontaneously disappear within a few weeks. I am not sure of the mechanism involved, either they dissolve or are passed via the bile duct into the GI tract. In fact at this page http://www.ultrasound-images.com/fetal-abdomen.htm , (see case-1), there is a case showing gall bladder calculi in a fetus. So, in the above case (neonatal GB calculi), we must conclude that the gallstones actually formed way up in the intrauterine period, possibly the last 3 months of gestation.
Studies have shown that gall stones (cholelithiasis) in infants/ children are mainly composed of dark bile pigment (calcium bilirubinate) whilst in adults the calculi are mainly of cholesterol crystals.