Bladder stone: “Must know” ultrasonographic signs

Koratala, Abhilash; Vangapalli, Ananthalaxmi; Bhattacharya, Deepti; Loy, Justin Lee

doi:10.1002/ccr3.1977

Cited by 4 publications

(4 citation statements)

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“…On gray-scale images, stones appear as hyperechoic or bright structures with a posterior “acoustic shadow”. Acoustic shadowing is the black area or signal void seen beyond structures that do not transmit ultrasound waves[34]. In the Doppler mode, stones exhibit “twinkling sign” or artifact, which refer to a rapidly alternating focus of color Doppler signals mimicking turbulent flow and is more pronounced with rougher stones.…”

Section: Common Sonographic Abnormalitiesmentioning

confidence: 99%

Point of care renal ultrasonography for the busy nephrologist: A pictorial review

Koratala¹,

Bhattacharya²,

Kazory³

2019

WJN

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The application of bedside ultrasonography in routine clinical practice has dramatically evolved over the last few decades and will likely continue to grow as technological advances lead to enhanced portability and affordability of the equipment. Despite mounting interest, most nephrology fellowship training programs do not offer formal training in renal ultrasonography and there is inertia among practicing nephrologists to adopt this skill as a practice-changing advancement. Lack of familiarity with the topic is considered a key reason for this inertia. Understanding of basic ultrasound physics, instrumentation, principles of optimal image acquisition and interpretation is critical for enhanced efficiency and patient safety while using this tool. Herein, we provide a brief overview of the basic principles of diagnostic renal ultrasonography as well as introduction to common sonographic pathologies encountered in day-to-day nephrology practice with illustrative images.

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Section: Common Sonographic Abnormalitiesmentioning

confidence: 99%

Point of care renal ultrasonography for the busy nephrologist: A pictorial review

Koratala¹,

Bhattacharya²,

Kazory³

2019

WJN

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“…The sonographic appearance of the stone is affected by its density and composition. If the ultrasound probe frequency was too low or the uroliths were not in the ultrasound beam's direct path, the shadow cones linked with the bladder calculi may not be evident 6,9 .…”

Section: Discussionmentioning

confidence: 99%

“…The presence of bacteria because of cystitis can alter the urinary pH level and promote stone formation. It's worth mentioning that cystitis can also occur due to urolithiasis caused by the contact between the bladder wall and the calculus 9 . However, more studies can indicate its origin.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Urolith in a Neutered Persian Cat: A Case Report

Asadi Ardebili,

Amin Razavi

2023

SAA

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Introduction: Uroliths or calculi are the formations of stones in the bladder. The formation of stones is influenced by specific metabolic conditions such as nutritional factors (e.g., protein-rich diet), hydration (lack of water), pH modification, low urine volume, hypercalcemia, or hypophosphatemia. In pet medicine, urolithiasis is common, particularly in cats. Case report: In October 2022, a 2-year-old neutered male Persian cat with a weight of 4 kg was referred to Ardebili Veterinary Pet Clinic (Mashhad, Iran) due to urinating outside the litter box, painful urination, and blood in the urine. A physical examination, ultrasonography, and blood analysis were performed. The physical examination included an assessment of the cat’s body temperature, heart rate, respiratory rate, mental state, mucous membrane color, capillary refill time, cardiopulmonary auscultation, and abdominal palpation. The cat appeared to be in good general health. No abnormalities were detected during the palpation of the bladder. Ultrasonography was performed using a real-time scanner with a 7.5-10 MHz broadband curvilinear probe, and the kidney parenchyma was examined. During the examination, a urolith with a size of 1 mm was observed. According to history and ultrasonography, and physical examination, the diagnosis was urolithiasis. To treat intermittent bladder pain, a spasmolytic drug (Prazosin) was administered at a dose of 0.5 mg/kg for 7 days. By the second day, the symptoms of pain had subsided. Additionally, ciprofloxacin at 20 mg/kg was used to combat infections. Fluoxetine at a 1 mg/kg dose was also administered to control inappropriate urination outside the litter box. After 3 days, the owner reported that the pet’s health improved, and most clinical signs disappeared. Conclusion: Administering appropriate medication (spasmolytic drug, antibiotic, and antidepressant in case of depressed animal and behavioral problems) can alleviate the calculi crystals in a cat’s urinary bladder and prevent future recurrences. In this instance, fluoxetine was discovered to be a successful option for managing pain and solving behavioral problems.

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“…Around the same time, the patient developed gross haematuria, flank pain and mild acute Kidney Injury with a serum creatinine 1.3 mg/dL (baseline ~0.9). A renal sonogram was obtained which showed non-obstructing bilateral renal stones with the classic acoustic shadowing and twinkling sign3 figure 2. She did not have known history of nephrolithiasis and review of CT of the abdomen prior to transplant confirmed the same.…”

Section: Descriptionmentioning

confidence: 99%