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(BQ) Part 2 book "Pocket protocols for ultrasound" presents the following contents: Kidneys, bladder, abdominal aorta, peritoneal free fluid, testicular ultrasound, lower extremity deep venous thrombosis, central venous access, peripheral venous access, arterial access,. | CHAPTER Kidneys Behzad Hassani The primary indication to perform a point-of-care ultrasound exam of the kidney is to evaluate for hydronephrosis. Any suspicious mass detected by point-of-care ultrasound warrants further investigation and expert consultation. A bladder ultrasound exam should accompany every renal ultrasound exam. A distended bladder due to bladder outlet obstruction is a common cause of hydronephrosis. Background Renal ultrasound provides a fast radiation-free and cost-effective alternative to computed tomography CT for the initial workup of low-risk patients who present with acute symptoms ranging from undifferentiated abdominal pain to painless hematuria.1 Ultrasound is the imaging modality of choice for investigating obstructive uropathy in pregnant and pediatric populations given the adverse effects of ionizing radiation. Focused renal ultrasound can accurately detect and grade hydronephrosis in the context of obstructive uropathy 2 directly visualize large obstructing calculi 3 and characterize renal cysts or solid masses.4 Renal ultrasound can be incorporated into the assessment of any patient with undifferentiated flank or abdominal pain. When clinical suspicion for renal calculus is high the presence of hydronephrosis on the side of pain can be considered as de facto evidence of obstructive uropathy. Sensitivity of ultrasound for detecting a calcified stone can be improved with the addition of a single plain film of the abdomen kidneys ureter and bladder or KUB .5 Severity of hydronephrosis observed may correlate with the duration of obstruction6 and possibly with the size of the obstructing calculus.7 When stone disease is clinically less likely or an alternate pathology such as abdominal aortic aneurysm gallbladder disease ovarian torsion or ectopic pregnancy is being considered the absence of hydronephrosis effectively guides investigations elsewhere. Normal Anatomy Kidneys are retroperitoneal organs that lie in an oblique longitudinal .
