Week 14 Renal Ultrasound by Jessica

HISTORY:
This is a 35 year old female who has been diagnosed with hyperparathyridism.

Please discuss the images, causes, treatments, prognosis, and any other information you find pertinent.

Week 13 Ob case study review by Evgeniya

Patient History: This is 33 Year old female. G3P2. 1st trimester Ob ultrasound performed. By today ultrasound is 10wk 5d viable fetal pole seen, with heart beat 182 bpm. Following are images:

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Image#5

Comments: Patient has heavy bleeding. US exam show viable fetal pole. Please look carefully at the image and explain why it is bleeding. What cause it? What are the consequences?

Week 12 ABD Case Study Review by Hye

Patient History: A 40 year male patient who had fatigue, headaches, weight loss, nausea, and appetite loss came for abdominal ultrasound exam. The patient had diabetes and high blood pressure.

Images:

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Description: The right kidney was 10.8x4.7x5.4cm, and the left kidney was 10.8x5.4x5.8cm. The patient's both kidneys showed increased echotextures. No evidence of renal stones or hydronephrosis was found. What is your opinion?

Wk 11 Blog 2 Case Review by Nancy

Patient History: A 23 yo female sent from her vertility clinic for complete pelvic exam and salpingogram. Pt having difficulty with pregnancy attempts. Your thoughts?

Week 11 Case Study by Nancy

36 yo female from the ER with vaginal bleeding and cramping. Pt states positive home pregnancy and she is undergoing IVF. She is AMA, GR-3, P-1, ab-1.

Pt had a CT earlier reporting a structure in rt adnexa.

Sonographic findings: No evidence of IUP, empty uterus

Rt and Lt ovary measurements WNL

What is the structure in the rt adnexa?

Week 10 ABD case study review by Flore

Case Review: This is a 45 year old female who was referred to my clinical site today for renal ultrasound due to the presence of blood in her urine. there were an incidental finding during my exam and the patient was asymptomatic. here are some of the images.


image1 this is a sag view and patient lie supine


image2 this is a trv view


image3 this is a decube sag view note the location has change


image4 this is a CBD measurement with Doppler


Comment: there were a negative murphy's sign; what do you think this may be? why is the patient asymptomatic? what can be the complication of this finding and what are the treatment
options if patient become symptomatic? add any comment you think may be interesting.

Week 10 Case Study Review by Leah

An 11-yr old girl presents with portal hypertension and elevated BUN lab values. She has had an abdominal ultrasound scan at least twice a year, for the past four years. Her older sister also came into the department to have an abdominal ultrasound scan. Linear, high-frequency transducers were used for some organs for a closer look, providing better resolution.
*Please comment on any abnormalities, prognosis, and treatment.

Image #1 Transverse Right Liver


Image #2 Transverse Left Liver

Image #3 Linear Liver

Image #4 Linear Liver

Image #5 Sagittal Spleen with Kidney

Image #6 Sagittal Left Kidney with measurement

Image #7 Linear Left Kidney

Image #8 Sagittal Right Kidney

Image #9 Sagittal Right Kidney with measurement

Image #10 Linear Right Kidney

Week 9 Case Study by Mimi

Presentation:

A 23 years old primagravida presented for routine sonographic scan with no significant complaints. According to the patient, menstrual age was approximately 30 weeks.



Image 1:
MR image confirms the presence of a high-riding third ventricle (arrow), pointed parallel anterior horns, and dilated occipital horn (colprocephaly).

Image 2:

Transverse sonogram of the fetal brain shows dilation of the occipital horn (curved arrow) and a high-riding third ventricle (arrow).

Image 3

Image 4: Axial fetal cranium

There is prominence of the ventricles but more in the occipital horns.

Image 5: Oblique fetal cranium

Image 6: long axis fetal femur

Image 7: long axis fetal femur

Image 8:

Another MR image shows wide divergence of the frontal horns and elevation of the third ventircle.

Comment:

There are two different diagnoses to this case. Visualization of the cavum septum pellucidum is absent in the fetal brain. There is an association with chromosomal disorders such as trisomy 18, holoprosencephaly, etc. of the fetal head. The fetal bone images represent a genetic disorder.

Week 9 OB Case Study by Tia

Case Review: 32 year old female with viable singleton IUP dating 17w6d per LMP. Patient referred to perinatal specialist due to abnormal anatomy scan at OB/GYN. Patient was late to prenatal care, today being her first ultrasound during this pregnancy. G2P1, with healthy 5 year old son. Nothing abnormal with previous pregnancy. No pertinent maternal or family history.

Images:


Image #1: SAG fetal spine (where is the cervical spine??? It’s on a different plane…YIKES)

Image #2: Coronal/ left fetus

Image #3: SAG midline fetal profile/thorax

Findings: U/S shows large anterior midline thoraco-abdominal wall defect with ectopia cordis and large ompahlocele. The spine has the appearance of severe scoliosis and extreme curvature in the thoracic portion, suggesting kyphosis. The amniotic fluid is quite generous at 26.4cm. The umbilical looked extremely short, but precise length measurement could not be obtained. Fetus showed little to NO movement. Follow up MRI confirmed the following:
1. Kyphoscoliosis
2. Ectopia cordis,
3. Polyhydramnios
4. Large omphalocele (containing liver, stomach, spleen, and almost all of the bowel) By MRI, omphalocele appears to be contiguous with the uterine wall (This is a very important finding that could not be determined with Ultrasound).

Previous to MRI, the diagnosis was suspected to be Pentralogy of Cantrell, but the supplementary MRI has led to a different diagnosis…. (Hint: Actual diagnosis is often a differential for Pentralogy of Cantrell)