Kidney ultrasound

Last revised by Daniel J Bell on 30 Jun 2023

Kidney or renal ultrasound is a non-invasive imaging technique that is widely used due to its safety, accessibility, and real-time capabilities.

Kidney ultrasound is commonly used in the evaluation and diagnosis of various renal disorders:

  • abdominal pain or flank pain

  • hematuria

  • urinary tract infection

  • renal stone

  • renal injury/failure

  • evaluation of congenital anomalies

  • detection and follow-up of cysts and tumors

  • post-operative evaluation, e.g. kidney transplant, partial nephrectomy

The following features are considered normal findings during a kidney ultrasound 2:

  • kidney size: normal adult kidneys measure around 9-13 cm in length, 4-6 cm in width, and 3-5 cm in thickness

  • kidney shape: bean-shaped with smooth contours

  • parenchyma: kidneys possess homogeneous echotexture with distinct corticomedullary differentiation

  • renal pelvis: central collecting system appears as hypoechoic structures with echogenic walls

Common abnormal findings in a kidney ultrasound can result from various conditions, including 3:

  • kidney ultrasound has a high accuracy in diagnosing kidney cysts, stones, and hydronephrosis; however, further imaging modalities like CT or MRI may be required for definitive diagnosis or staging of diseases 4

  • additional diagnostic tests such as blood tests and urinalysis are often employed alongside kidney ultrasounds to provide a comprehensive evaluation of renal function and pathology

  • often, it is necessary to have patients take deep breaths and hold them during scanning to improve visualization of upper pole of kidneys as it pushes the organs away from the rib cage

  • Doppler imaging can be utilized to evaluate renal blood flow and detect any vascular abnormalities 4

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