KIDNEYS & BLADDER
GU Ultrasound Pearls & Pitfalls
- Image the entire organ using a fanning motion. Don’t just go for one pretty static shot through the middle.
- If you have a difficult time imaging the left kidney, have the patient hold their breath to bring the kidney more inferior.
- Any abnormal findings should be confirmed with formal imaging.
- Hydronephrosis is seen as a black or anechoic area in the center of the kidney and represents obstruction.
- Because you have two kidneys, any questionable findings on side may benefit from a comparison view
- Always take a look at the aorta. It’s essential to practice looking a normal anatomy and even more essential to pick up an aneurysm before it ruptures.
- Don’t miss renal obstruction in the setting of urosepsis
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Want more educational images? Check out the ED Atlas on CD
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Renal and Bladder Ultrasound from the ED
Normal Right Kidney
Normal Left Kidney
Normal Bladder

Painless hydronephrosis, unsuspected, in a patient with urosepsis
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Massive Hydronephrosis: Congenital and asymptomatic
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Hydronephrosis with Intra-renal Caliculi
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Polycystic Kidney Disease
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Bladder Tumor
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