Fatty Liver Disease – Ultrasound
History: 50 year old male with right upper quadrant pain. This is the typical appearance of fatty liver disease, also called hepatic steatosis, on ultrasound. The three main findings of fatty liver disease on ultrasound are 1) increased echogenicity as compared to the adjacent kidney (which must be measured at the same depth), 2) decreased acoustic […]
Choledocholithiasis
History: 40 year old female with right upper quadrant pain. This constellation of findings gives the diagnosis of choledocholithiasis, which is the presence of a stone within the biliary ductal system. A classic ultrasound finding with calcified stones is posterior acoustic shadowing, however, the appearance of gallstones is based upon the location, size, and composition. […]
Ascites on Ultrasound
History: 50 year old male with abdominal pain and swelling. This is the typical appearance of ascites on ultrasound. The right upper quadrant of the abdomen, particularly in Morrison’s Pouch, also known as the hepatorenal recess, is a great place to look for free fluid.
Ectopic Pregnancy – The Tubal Ring Sign, Ring of Fire, and Pseudogestational Sac
History 28 year old female presenting with right lower quadrant pain. Positive urine pregnancy test. This is a case of a tubal ectopic pregnancy. The differential diagnosis in this case includes corpus luteum of pregnancy, incidental adnexal mass, and intrauterine pregnancy. A corpus luteum of pregnancy will typically show the classic “ring of fire” pattern, […]
Superficial Venous Thrombosis to Deep Venous Thrombosis
History: 55 year old female seen five days earlier with a diagnosis of superficial thrombophlebitis returns with continued and worsening leg swelling. This is a case of extension of a superficial venous thrombus into the deep venous system of the leg from the short saphenous vein to the popliteal vein. In patients with superficial […]
Superficial Thrombophlebitis
History: 60 year old female with lower extremity pain, swelling, and redness. This is a case of superficial thrombophlebitis, which is an inflammatory-thrombotic disorder of the superficial venous system. Typically it presents with pain, swelling, and warmth in the lower extemities with a “palpable cord,” which represents a thrombosed vein, as in the image above. […]
Ovarian Fibroma on Ultrasound
History: 40 year old female with pelvic pain. The imaging appearance here is consistent with a solid adnexal mass. The differential diagnosis in this case includes pedunculated uterine fibroid, ovarian torsion, Brenner Tumor, fibroma or fibrothecoma, lymphadenopathy, GI tumors and Bladder tumors. The final diagnosis on pathology was ovarian fibroma. These are benign tumors of […]
Appendicitis – On Ultrasound
History: 25 year old female with acute lower abdominal pain, nausea and vomiting. Given the history, this is essentially diagnostic of appendicitis. Take a look again at the image. The appendix has a target appearance, which also aids in the diagnosis. The target appearance is caused by edema within the various layers of the appendix […]
Vasa Previa
History: 25 year old female G5P0 presents for fetal anatomy scan at 19 weeks gestational age. This is the ultrasound appearance of vasa previa. Vasa previa is when the umbilical cord vessels course across the internal cervical os, putting the patient and baby at risk for hemorrhage during delivery. Vasa previa is seen independently of […]
Mullerian Duct Anomalies: Uterine Didelphys
History: 18 year old female with pelvic pain. This is the classic appearance of uterine didelphys. Mullerian duct anomalies are classified according to the American Fertility Society system here. Occasionally a uterine horn can become obstructed and cause hematocolpos, or hematometrocolpos.