Imaging Flashcards
What is the usual cause of renal colic
Ureteric calculus
Stone
Which tests are used to diagnose ureteruc calculi
KUB X-ray - first test
CT - definitive
MRI
What are most calculi composed of
Most are dense and rich in calcium - easier to image
List places where renal calculi often get stuck
Pelviureteric junction (PUJ), pelvic brim and vesicoureteric junction
How do you follow up a renal calculi
Most pass by themselves
Use the simplest test that showed the calculi the first time to track progress
What is macroscopic haematuria
Visible blood in the urine
What can cause macroscopic haematuria
Calculi Infection Tumour Urethritis/prostatitis Trauma Clotting disorders
How would you investigate macroscopic haematuria in the over 50s
CT urography
Cystoscopy - examine bladder and urethra with scope
May go onto uteroscopy if indicated
How do you carry out CT urography
Do CT before contrast
Then give IV contrast, wait 15mins to let it be excreted by kidneys
Then give top up dose 60s before scan to enhance the kidneys themselves
Then do a second CT scan
What is CT urography used to check for
Renal parenchymal tumours
Urothelial tumours of the collecting systems or ureters
How would you investigate macroscopic haematuria in the under 50s
US of kidney
Cytoscopy
CTU only when these are normal
What size of mass will rarely metastasize
Under 3cm
Will just be followed up, not operated on
Renal masses containing fat are likely to be what
benign angiomyolipomas
Fluid density masses in the kidney are likely to be what
Cysts
If uniform in shape it is likely to be benign
Where do renal tumours often metastasise to
Lung
Bone
