Hematuria ultrasound: Difference between revisions

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{{Hematuria}}
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{{SCC}};{{AE}}{{VSKP}}
{{CMG}} ; {{AE}} {{SCC}} , {{Adnan Ezici}} , {{VSKP}}


==Overview==
==Overview==
Ultrasound(US) offers an accurate, noninvasive approach to rule out [[obstructive uropathy]], determine renal size and cortical thickness, and look for masses or cysts. The availability of color duplex to assess renal vascular flow and resistance provides additional information regarding renal parenchyma. US is the first choice among the imaging studies to evaluate a patient with deterioration in renal function, because it does not involve the usage of nephrotoxic contrast media. US is the imaging test to consider in patients with suspected glomerular hematuria, as manifested by dysmorphic RBCs, proteinuria of at least 2+, and RBC casts. Because radiation is not involved, US is safe in pregnant patients as well. It is less accurate in detecting ureteral lesions such as nonobstructing stones, and thus may not be the first choice for evaluating a suspected urological cause of hematuria.<ref>{{cite book | last = Rew | first = Karl | title = Primary care urology | publisher = Saunders | location = Philadelphia, Pa. London | year = 2010 | isbn = 978-1437724899 }}</ref>
Ultrasound may be helpful in the evaluation of hematuria. Ultrasound(US) offers an accurate, noninvasive approach to rule out [[obstructive uropathy]], determine renal size and cortical thickness, and look for masses or cysts. The availability of color duplex to assess renal vascular flow and resistance provides additional information regarding renal parenchyma.
 
==Ultrasound==
==Ultrasound==
Ultrasound may be helpful in the evaluation of hematuria. US is the first choice among the imaging studies to evaluate a patient with deterioration in [[renal]] function, because it does not involve the usage of [[nephrotoxic]] contrast media. US is the imaging test to consider in patients with suspected [[glomerular]] hematuria, as manifested by dysmorphic RBCs, proteinuria of at least 2+, and RBC casts. US is safe in pregnancy. It is less accurate in detecting ureteral lesions such as nonobstructing stones, and thus may not be the first choice for evaluating a suspected urological cause of hematuria.<ref>{{cite book | last = Rew | first = Karl | title = Primary care urology | publisher = Saunders | location = Philadelphia, Pa. London | year = 2010 | isbn = 978-1437724899 }}</ref>
[[File:Renal-stone.png|thumb|center|5 mm renal stone detected by ultrasonography (USG). (Case courtesy of Dr Mohamed M. Yosef, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/63209">rID: 63209</a>)]]
'''Advantages'''
'''Advantages'''
* Ultrasound of the abdomen and pelvis is safe.<ref name="Surgery (Oxford)">{{cite web |url=http://www.surgeryjournal.co.uk/article/S0263-9319(10)00199-7/abstract |title=www.surgeryjournal.co.uk |format= |work= |accessdate=}}</ref><ref name="pmid230987842">Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ et al. (2012) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=23098784 Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline.] ''J Urol'' 188 (6 Suppl):2473-81. [http://dx.doi.org/10.1016/j.juro.2012.09.078 DOI:10.1016/j.juro.2012.09.078] PMID: [https://pubmed.gov/23098784 23098784]</ref>
* Ultrasound of the abdomen and [[pelvis]] is safe.<ref name="Surgery (Oxford)">{{cite web |url=http://www.surgeryjournal.co.uk/article/S0263-9319(10)00199-7/abstract |title=www.surgeryjournal.co.uk |format= |work= |accessdate=}}</ref><ref name="pmid230987842">Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ et al. (2012) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=23098784 Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline.] ''J Urol'' 188 (6 Suppl):2473-81. [http://dx.doi.org/10.1016/j.juro.2012.09.078 DOI:10.1016/j.juro.2012.09.078] PMID: [https://pubmed.gov/23098784 23098784]</ref>
* It is good at detecting
* US is good at:
* Detecting renal parenchymal lesions (e.g. renal cell carcinoma)
** Detecting renal parenchymal lesions (e.g. renal cell carcinoma)
* For characterizing renal cysts Showing renal calculi
** Characterizing [[Renal cysts|renal cyst]]
* For determining ureteric obstruction (Hydronephrosis)
** Detecting renal calculi
** Determining ureteric obstruction (Hydronephrosis)
'''Disadvantages:'''
'''Disadvantages:'''
* US is poor at detecting small lesions within the collecting system (e.g. urothelial cell carcinoma (UCC) of the renal pelvis)
* US is poor at detecting small lesions within the collecting system (e.g. urothelial cell carcinoma (UCC) of the renal pelvis)
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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[[Category:Nephrology]]
[[Category:Nephrology]]
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[[Category:Urologic Disease]]
[[Category:Urologic Disease]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Primary care]]
{{WH}}
{{WS}}

Latest revision as of 11:25, 14 August 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Steven C. Campbell, M.D., Ph.D. , Adnan Ezici, M.D[2] , Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [3]

Overview

Ultrasound may be helpful in the evaluation of hematuria. Ultrasound(US) offers an accurate, noninvasive approach to rule out obstructive uropathy, determine renal size and cortical thickness, and look for masses or cysts. The availability of color duplex to assess renal vascular flow and resistance provides additional information regarding renal parenchyma.

Ultrasound

Ultrasound may be helpful in the evaluation of hematuria. US is the first choice among the imaging studies to evaluate a patient with deterioration in renal function, because it does not involve the usage of nephrotoxic contrast media. US is the imaging test to consider in patients with suspected glomerular hematuria, as manifested by dysmorphic RBCs, proteinuria of at least 2+, and RBC casts. US is safe in pregnancy. It is less accurate in detecting ureteral lesions such as nonobstructing stones, and thus may not be the first choice for evaluating a suspected urological cause of hematuria.[1]

5 mm renal stone detected by ultrasonography (USG). (Case courtesy of Dr Mohamed M. Yosef, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/63209">rID: 63209</a>)

Advantages

  • Ultrasound of the abdomen and pelvis is safe.[2][3]
  • US is good at:
    • Detecting renal parenchymal lesions (e.g. renal cell carcinoma)
    • Characterizing renal cyst
    • Detecting renal calculi
    • Determining ureteric obstruction (Hydronephrosis)

Disadvantages:

  • US is poor at detecting small lesions within the collecting system (e.g. urothelial cell carcinoma (UCC) of the renal pelvis)

References

  1. Rew, Karl (2010). Primary care urology. Philadelphia, Pa. London: Saunders. ISBN 978-1437724899.
  2. "www.surgeryjournal.co.uk".
  3. Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ et al. (2012) Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol 188 (6 Suppl):2473-81. DOI:10.1016/j.juro.2012.09.078 PMID: 23098784

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