Urinary Tract

Case from the Ultrasound of the Week

52 y/o female with a history previous cervical cancer presents stating that she has not urinated in two days, c/o abdominal pain and some distention.  i-stat labs show a creatinine of 7.5.  What is the likely etiology of these findings?

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What to Learn 

1. Describe the indications, contraindications, and limitations of urinary tract CUS.
2. Identify clinically relevant sonographic anatomy of the genitourinary system. 
3. Perform the CUS protocol required.
4. Recognize the relevant focused findings and pitfalls when evaluating for hydronephrosis, renal calculi, renal masses, and bladder size.

What to Read: Introduction to Bedside Ultrasound
Free iBook download Vol 1 and Vol 2

Chapter 6: Renal

Where to Learn More

US Podcasts

Renal US 5/6/2012

ACEP US Section Resources
ACEP Renal Ultrasound Page by Barbara Klok and Beatrice Hoffmann
ACEP Renal and Testicular Test by Mike Stone and Rob Blakenship

SAEM Academy of EUS Resources
Renal Ultrasound by Peregrine Dalziel
Emergency Ultrasound by Geoff Hayden 
Renal Lecture
Key Articles

1. Consensus. ACEP Emergency ultrasound guidelines. Ann Emerg Med. 2009;53(4):550–570.
2. Ultrasound E, Criteria I. ACEP Emergency Ultrasound Imaging Criteria Compendium.; 2006. Available at: http://www.acep.org/ultrasound/
3. Gaspari RJ, Horst K. Emergency ultrasound and urinalysis in the evaluation of flank pain. Acad Emerg Med. 2005;12(12):1180–4..
4. Herbst MK, Rosenberg G, Daniels B, et al. Effect of Provider Experience on Clinician-Performed Ultrasonography for Hydronephrosis in Patients With Suspected Renal Colic. Ann Emerg Med. 2014. doi:10.1016/j.annemergmed.2014.01.012.
5. Moore CL, Bomann S, Daniels B, et al. Derivation and validation of a clinical prediction rule for uncomplicated ureteral stone--the STONE score: retrospective and prospective observational cohort studies. Bmj. 2014;348(mar26 2):g2191–g2191.

Test Yourself

Urinary Tract