Plain Film Imaging?
Cheap, but does use radiation, often first imaging modality.
- Useful for finding 'radio-opaque' (most common, calcium-filled) kidney stones
Look for them along the lines of the Ureters (along T. processes)
What are the non-opaque kidney stones you can get?
Non-calcified stones filled with uric acid , common in maori men with gout. Hard bc they can't be seen!
How does a patient with Renal Colic present?
'Loin-to-groin' pain. In men can even start at the testis.
Patient extremely restless due to incredibly pain that is coming in waves. (**whereas appendicitis is so sore for them to move at all)
Blood in urine, decreased urine output.
Why are the little stones the problem?
because they are the ones that drop out of the kidney and make their way down the ureters (5mm), and big ones can't get anywhere.
Ultra sound, although extremely useful (esp for kidney stones/mass, bladder issues) and with no radiation, is operator/patient-dependant. How is this an issue?
Patients are getting fatter. The fatter the patient, the harder it is of getting down to the kidneys are significantly reduced.
Why can't US find the ureters?
Because we can't see through the air that is within the bowels!
Pros and cons of CT scan?
- More accurate, assess soft tissue, fluid calcification
- Expensive and uses radiation. May need to inject dye.
What is this?
An ultrasound of a normal kidney
What does this tell us?
Right side has been given the contrast, whereas the left isn't indicating a blocking (in this case cancer)
What is this?
Coronal CT scan of kidney. Can see anatomy of kidney
Pros/cons of MRI
- Even more accurate for soft tissues!
- MORE expensive, and a much longer scan time of 30-45 mins (so a wriggling patient wont work)
Differences of Renal imaging at different stages of life?
Different clinical concerns/radiation issues.
Kidney issues with Antenatal babies?
- Congenital abnormalities (eg: no kidneys 'agenesis', polycystic kidneys)
- Obstructed Kidneys (at level of renal pelvis, post. uretral valve that blocks bladder flow "dribbly urine!")
How does stone size on CT correlate with patient treatment?
Tells us if it's gonna pass naturally or need intervention.
Cut-off = ~6mm
over >6mm there's a 99% need for intervention?