The fetal urinary bladder, also known as the bladder bubble, is visible as an anechoic cyst on ultrasound in most fetuses from 12-13 weeks of gestation 1.
The size of the bladder is denoted by measuring the longitudinal bladder diameter from superiorly to inferiorly in the sagittal plane. Age-r...
Prostatic stromal nodules are type of nodule that can arise from benign prostatic hyperplasia. They may comprise of immature mesenchymal, fibroblastic, fibromuscular and smooth muscular elements.
They are typically seen in the transitional zone or occasionally may pr...
Pyelolithiasis is calculus or calculi located centrally within the renal pelvis.
Other terminologies that may be used interchangeably with pyelolithiasis to refer to these calculi include renal stones, urolithiasis, and nephrolithiasis. A calculus located within the renal calyx can...
A renal autotransplant is an uncommon procedure in which a kidney is resected from its native site and implanted in a new location.
This infrequently performed procedure is most commonly done for 1,3:
loin pain haematuria syndrome
Penile Mondor disease is a benign self-limiting condition of the penis characterised by thrombophlebitis of the superficial dorsal vein of the penis or one of its tributaries.
Mondor disease also occurs in the breast and axilla.
It usually occurs in sexually active young adults. ...
The male pelvic ultrasound is a noninvasive, painless and effective diagnostic imaging technique used for evaluating and examining the pelvic region, specifically the lower abdomen, bladder and prostate gland in males.
Some common indications for male pelvic ultrasound are 1,2:
Lutetium-177 vipivotide tetraxetan, trade name Pluvicto, also known as 177Lu-PSMA-617, is a theranostic (i.e. both therapeutic and diagnostic) agent approved as a treatment for adult patients with treatment-resistant advanced metastatic prostate cancer. The treatment works by binding to cancer ...
Adrenal glands ultrasound, is an imaging method that can provide valuable information regarding their size, shape, and structure. As a result, it can aid in diagnosing various pathological conditions related to adrenal gland function.
Several ultrasound techniques can be employed to...
Renal cyst sclerotherapy is a minimally invasive procedure performed to treat symptomatic simple renal cysts (i.e. Bosniak I) and is one of the primary methods to treat renal cysts along with surgical cyst de-roofing 1.
Note: This article is intended to outline some general principles of the pr...
A scrotal wall abscess is the formation of an abscess within the scrotal wall.
Patients may present with an acute tenderness within scrotum usually with overlying erythema, fluctuant mass and sepsis.
May occur from two mechanisms:
primary superficial infectio...
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
PSMA theranostics is an emerging nuclear medicine approach in the management of prostate cancer that combines the use of prostate-specific membrane antigen (PSMA)-targeted imaging and therapy 1. PSMA-targeted imaging can be used to identify and locate prostate cancer cells, while PSMA radioligan...
Cellulitis of the scrotum is an uncommon but essential condition as it can lead to Fournier gangrene, especially in the immunosuppressed or diabetics.
thickening of the scrotal skin
gross oedematous swelling of the scrotum
increased blood flow in the scrotum on colour D...
Urinary bladder cysts are considered tumour-like lesions and true simple cysts arising from the bladder wall are extremely rare 1.
Three types of cysts have been described 1:
urachal cysts: dome and anterior wall
cloacal cysts: posterior wall
simple cyst of the bladder w...
Brunn cysts or mucous cysts of the urinary bladder are considered to originate from von Brunn nests as the result of pinching off of epithelial nests from urothelial buds. Cysts in the urinary bladder are considered as tumour-like lesions.
Most Brunn cysts are asymptomati...
Von Brunn nests are non-neoplastic reactive urothelial lesions that occur in the bladder. They represent clusters of urothelial cells found in the superficial lamina propria resulting from the invagination of the superficial urothelium.
Histologically, those nests generally show uniform size a...
Disseminated histoplasmosis, also known as progressive disseminated histoplasmosis, is a severe form of histoplasmosis infection typically seen in immunosuppressed patients, especially in the setting of HIV infection. It results from haematogenous dissemination of the infection, involving multip...
Magnetic resonance urography (MR urography) is a MRI study that predominantly used to image congenital abnormalities of the urinary system. There are two types of MR urography: static fluid-sensitive urography that is heavily T2-weighted to image the fluid-filled urinary system and excretory MR ...
Jewett-Strong-Marshall tumour staging system for bladder cancer is of historic interest only and has been superseded by the TNM staging system.
stage 0: epithelial
stage A: submucosal invasion but no involvement of muscle i.e. lamina propria
stage B: bladder wall or muscle invasion
Michaeliis-Gutmann bodies are a histological feature characteristic of malakoplakia, typically seen in mid-stage disease 1,2.
They are 1–10 μm laminated or targetoid basophilic focal inclusions of iron and calcium salts seen on light microscopy. They are also periodic acid–Schiff, and diastase-...
Inflammatory leiomyosarcomas are malignant tumours with smooth muscle differentiation and a prominent inflammatory infiltrate that were just recently recognised as a distinct entity by the WHO in 2020 1-3.
Inflammatory leiomyosarcomas are very rare lesions with most cases seen in ...
Anastomosing haemangiomas are benign vascular neoplasms consisting of thin-walled anastomosing vessels. These lesions have been just recently added to the WHO classification of soft tissue tumours in 2020 as a separate entity 1-3
Anastomosing haemangiomas are rare lesions with a w...
Tubulointerstitial nephritis is a condition where the inflammation is mainly in or around the renal tubules. It may be acute or chronic.
Tubulointerstitial nephritis may affect any age group ranging from paediatric to adult.
Tubulointerstitial nephritis can ...
The thoracic splanchnic nerves are three paired autonomic nerves that provide sympathetic innervation of the abdominopelvic viscera and vessels. They contain efferent and afferent fibres.
Three pairs of thoracic splanchnic nerves arise from the T5 to T12 sympathetic ganglia.
The renal plexus (plural: plexuses) is an autonomic nerve plexus and ganglia located in the upper abdomen and is a lateral perivascular extension of the aorticorenal plexus.
location: bilateral plexuses and ganglia lie on the renal arteries lateral to the aorticorenal plexuses
The aorticorenal plexus (plural: plexuses) is an autonomic nerve plexus and ganglia located in the upper abdomen and is an inferior perivascular extension of the larger coeliac plexus. Some descriptions separate the aortic and aorticorenal plexuses but they are considerably interconnected and co...
The ganglion impar, also know as the ganglion of Walther, is the midline autonomic ganglion located in the lower pelvis. It is the most distal convergence of the pelvic sympathetic chain which is usually located anterior to the coccyx. It can be found anywhere between the sacrococcygeal joint a...
The gonads (single: gonad) are the paired reproductive organs of humans responsible for the production of gametes and sex hormones. The anatomy of the gonadal arteries differs substantially between the sexes, hence they are covered separately:
ovaries in the female located in the pelvis
The autonomic ganglia and plexuses are a collection of ganglia where autonomic preganglionic neurones arising from the CNS synapse with postganglionic neurones outside the CNS, i.e. in the peripheral nervous system. Many of the ganglia contain nerves of the sympathetic and parasympathetic nervou...
This article lists examples of normal imaging divided by body region and system.
head and neck
Cystitis refers to inflammation of the urinary bladder. It may occur in isolation or be associated with inflammation of other parts of the urinary tract such as ureteritis or pyelonephritis.
Cystitis is more common in females due to the short length of the urethra and its close pr...
The post-void residual refers to the volume of urine that remains in the urinary bladder after micturating. It may be estimated by visualisation using ultrasound or directly measured with urethral catheterisation
Use of this measurement is of some utility in several disti...
Acceleration index is an indirect sonographic sign to assess renal artery stenosis 1.
Acceleration index is used in the Doppler assessment of the renal arteries when assessing for renal artery stenosis.
Acceleration index is calculated by subtracting the initial systolic ve...
The anococcygeal raphe (plural: anococcygeal raphes or raphae), also known as the anococcygeal ligament or anococcygeal body refers to the midline structure that connects the anorectal junction to the coccyx. It is composed of bilateral interdigitating fibres from the iliococcygeal and pubococcy...
Testicular torsion-detorsion syndrome or intermittent testicular torsion refers to acute and periodic testicular pain due to limited blood flow, integrated with asymptomatic periods 1. Testicular torsion-detorsion syndrome has increasingly been reported in the literature.
Encysted spermatic cord hydroceles are one of the subtypes of spermatic cord hydrocoele where the fluid collection does not communicate with the peritoneum above or the tunica vaginalis below.
In this encysted type, a loculated hydrocoele occurs along the spermatic cord due to oblit...
Chemical ablation is a technique in which chemical ablative substances are used to cause cell death in neoplastic tissue. It is used as a standalone procedure or in combination with other techniques like TACE and radiofrequency ablation.
absolute ethanol (most commonly used)
Renal large cell neuroendocrine carcinomas are an extremely rare renal tumour, with only six cases reported in the literature (c. 2022) 1.
Renal large cell neuroendocrine carcinoma represents <1% of the total reported cases of primary renal cancers. The most affected population ...
Metanephric adenofibroma, originally referred to as 'nephrogenic adenofibroma', is a rare, biphasic, and benign metanephric tumour.
Metanephric adenofibroma typically occurs in children and young adults with a mean age of 13 years 1,3.
Patients present wit...
Metanephric stromal tumour (MST) is a very rare, benign renal neoplasm that predominantly affect children.
Metanephric stromal tumour is characterised by pure stromal morphology, hyper-differentiation, and no metastasis. The median age of diagnosis was 2 years. Less than fifty c...
The Effman classification is a widely adopted system to classify the several distinct types of urethral duplication. It's considered to be the most complete classification from a clinical and functional point of view, but it's only based on male forms and does not distinguish sagittal from coron...
Clitoral ultrasound is a modality for imaging clitoral pathology, which can be the aetiology of female sexual dysfunction. It can also be performed before and after gynaecologic surgery to assess clitoral anatomy and blood flow. The exam involves a transperineal component.
Normal ultrasound ana...
Nephrostogram, also known as antegrade pyelogram, is a special x-ray procedure that fluoroscopically evaluates the upper collecting system by introducing water-soluble contrast through the nephrostomy catheter.
Nephrostogram can be useful to determine tube position or assess resid...
Ovarian agenesis refers to a situation where there is a congenital absence of the ovary.
Unilateral ovary agenesis affects approximately 1 in 11,240 women while bilateral agenesis is even rarer 1.
Most patients with agenesis of the ovary are asymptomatic....
The characteristic shape of the crescent has been given to many radiological signs over the years:
air crescent sign (aspergillosis)
crescent in a doughnut sign (intussusception)
crescent sign (arterial dissection)
crescent sign (intravenous pyelogram)
crescent sign (lung hydatid)
The doughnut sign, also known as the bull's-eye, halo or ring sign, is the name of a distinctive appearance of a missed testicular torsion on scrotal scintigraphy.
In a missed torsion (i.e. established testicular infarction), there is a reactive hyperperfusion of the ipsilateral dartos muscle ...
Hypovascular retroperitoneal lesions are those which do not enhance in the late arterial and portal venous phases on CT. Some of these lesions may show progressive enhancement in the delayed phase due to their fibrous or myxoid matrix components.
Hypervascular retroperitoneal lesions are findings that enhance avidly in the late arterial phase with or without washout in the portal venous and delayed phases, on contrast-enhanced CT or MRI.
Early enhancement with slow washout
The salt and pepper sign has been given to the heterogeneous echotexture of the enlarged kidneys on ultrasound in children with autosomal recessive polycystic kidney disease (ARPCKD).
Penile calcifications are a relatively rare finding. The commonest cause is Peyronie disease.
penile calciphylaxis (considered by some to be a form of calcinosis cutis)
penile urethral calculus
calcinosis cutis of the penis
idiopathic calcinosis cutis ...
The superior hypogastric plexus is an autonomic nerve plexus and ganglia located in the lower abdomen.
location: the plexus and ganglia lie anterior to the aortic bifurcation extending inferiorly between the common iliac arteries and along the left common iliac vein and median sacral v...
Dent disease is a very rare inherited renal disorder that is characterised by proximal tubule dysfunction.
hypercalciuria, renal stones and nephrocalcinosis
proteinuria, although not presenting with nephrotic syndrome
The renal mass CT protocol is a multi-phasic contrast-enhanced examination for the assessment of renal masses. It is most often comprised of a non-contrast, nephrogenic phase and excretory phase. However, this article will cover the optional, corticomedullary phase too.
NB: This article is inte...
The excretory phase also known as the urographic phase is a postcontrast injection time range in which there is an optimal enhancement of the renal collecting systems.
The acquisition time depends on the intravenous device (central or peripheral), the concentration of the contrast me...
A commissure (TA: commissura) is a location at which two anatomical structures are united. Though the term most commonly refers to the commissures in the brain, there are a number which exist in the human body:
central nervous system
Multisystemic smooth muscle dysfunction syndrome is a rare genetic disorder caused by mutations in the ACTA2 gene, resulting in intracranial steno-occlusive disease and aortic dissection or aneurysm, among other complications.
Most cases are diagnosed in childhood 1.
Pelvic organ prolapse refers to a pathological downward herniation of various pelvic organ structures into or through the perineum. It usually results from a pelvic floor weakness by impairment of various ligaments, fasciae, and muscles that support the pelvic organs.
In its most severe form it...
Clear cell papillary renal cell carcinoma is a subtype renal cell carcinoma.
Generally uncommon but thought to be the fourth most common histologic type of renal cell carcinoma at the time of new classification (c. 2016) 1.
This subtype is characterised by low-grade, c...
The deep artery of the penis, also known as cavernosal artery, is one of the two terminal branches of the internal pudendal artery.
The internal pudendal artery bifurcates terminally into the deep artery of the penis and the dorsal artery of the penis at the anterior marg...
The dorsal artery of the penis is one of the two terminal branches of the internal pudendal artery.
The internal pudendal artery bifurcates into the deep artery of the penis and the dorsal artery of the penis at the anterior margin of the perineal membrane 1.
The artery to the bulb of the penis (male) or vestibule (female) is a branch of the internal pudendal artery. It differs slightly in males and females.
Artery to the bulb of the penis
Origin: internal pudendal artery, distal to the perineal artery1.
a common penile artery, serving as the or...
Lymphangiomatosis is a rare mesenchymal disorder that is characterised by developmental "malformation" of multiple lymphatic channels (usually with dilatation).
If lymphatic channels are purely dilated and not malformed the term lymphangiectasia is usually used. If lymphangiomatosi...
The Mitrofanoff procedure, also known as appendicovesicostomy, is a surgical procedure where a conduit is created using the appendix to form a connection between the urinary bladder and skin surface. Intermittent catheterisation is performed through the surgically constructed conduit, thus provi...
The perineal artery arises from the internal pudendal artery and supplies some of the perineal musculature and external genitalia.
Origin: branches off the internal pudendal artery, arising at the level of the posterior angle of the perineal membrane
Branches: it has two branches:
Carcinoma of the Littré glands is rare. The Littré (urethral) glands of the penis may be the origin of cancers of the penis, usually adenocarcinomas 1.
There are only a few scattered case reports of true Littré gland malignancy, although it is probably under-reported due to the fa...
A sphincter (TA: musculus sphincter) is a term used in anatomy to refer a ring of muscle which narrows a tube or closes off a bodily orifice 1.
external anal sphincter
internal anal sphincter
lower oesophageal sphincter
Renal artery calcifications, also known as renovascular calcifications, are deposits of calcium salts on the wall of a renal artery, found incidentally on imaging, usually CT 1. They are associated with extrarenal atherosclerosis and linked to hypertension 2.
The term “renal artery...
A mnemonic to remember the commonest micro-organisms responsible for urinary tract infections (UTIs) is:
K: Klebsiella spp.
E: Enterococcus faecalis / Enterobacter cloacae
E: Escherichia coli
P: Pseudomonas aeruginosa / Proteus mirabilis
S: Staphylococcus saprophyticus / S...
A mnemonic to remember the basic indications of dialysis is
H: hyperkalaemia (refractory)
A: acidosis (refractory)
V: volume overload
E: elevated BUN > 35 mM
E: oedema (pulmonary)
A mnemonic to remember the commonest causes of haematuria is:
I PEE RBCS
P: pseudohaematuria (menses, dark urine)
E: external trauma
R: renal glomerular disease
B: benign prostatic hypertrophy
The nephrogenic phase, also known as the nephrographic phase or the renal parenchymal phase, is a postcontrast injection time range in which there is an optimal enhancement of the renal parenchyma including the medulla.
The acquisition time depends on the intravenous device (central ...
A tension hydrocele is a rare form of hydrocele that may result in impeded arterial inflow and venous outflow to and from the testis 1; testicular ischaemia may result, leading to necrosis of the testicular parenchyma 2.
Tension hydrocele can be diagnosed through a combination of cli...
Squamous cell carcinoma (SCC) of the penis is an uncommon condition that often presents at an advanced stage. Imaging is more often used for staging than for the initial diagnosis. It is the commonest histological subtype of penile cancer.
Penile cancer is a relatively infrequent ...
Renal imaging in nuclear medicine is a method to assess the kidneys and collecting systems via multiple different radioactive tracers.
Dynamic renal imaging is performed using Tc-99m MAG3 or Tc-99m DTPA, and static renal imaging is performed with Tc-99m DMSA. In addition, Tc-99m DTPA can be use...
The coiled catheter sign is sometimes seen in transitional cell carcinoma of the ureter. When a retrograde ureteropyelogram is attempted in the afflicted ureter, the catheter tip is seen to coil in the dilated portion of the ureter distal to the obstruction 1.
The CT chest-abdomen-pelvis protocol serves as an outline for an examination of the trunk covering the chest, abdomen and pelvis. It is one of the most common CT examinations conducted in routine and emergencies. It can be combined with a CT angiogram.
Note: This article aims to frame a genera...
A spontaneous rupture of the urinary bladder is usually on a background of a pre-existing pathology and is a urological emergency.
For a general discussion of the perforation of the urinary bladder, please refer to the article on urinary bladder rupture.
Intraperitoneal bladder t...
The urogenital diaphragm is an incorrect historic term describing a structure or structures in the perineum. The term is still in frequent use despite not appearing in Terminologia Anatomica.
Most descriptions of the diaphragm relate to a discoid space between the superficial and deep fasciae o...
Prostatic atrophy is characterised by reduced cytoplasm prostatic acinar cells and constitutes a benign mimic of prostate cancer not only on imaging but also histologically.
The term 'proliferative inflammatory atrophy (PIA)' is used if it is associated with inflammation.
The tulip sign is a sonographic clue for in utero diagnosis of severe hypospadias.
The configuration of a tulip is given by the severe curvature of the penis in association with the penoscrotal transposition of a bifid scrotum.
History and etymology
The tulip sign was first described in 2002 ...
Prostatic leiomyomas are benign mesenchymal tumours of the prostate.
Prostatic leiomyomas are very rare 1-3.
The diagnosis of prostatic leiomyoma is based on histology.
Prostatic leiomyomas can present with voiding difficulties or obstructive sy...
Seminal vesicle cystadenomas are a benign subgroup of mixed epithelial and stromal tumours of the seminal vesicles.
Benign tumours of the seminal vesicles are very rare and so are cystadenomas 1.
Voiding difficulties or haematuria have been reported as clin...
Seminal vesicle stones or calculi refer to solid mineralised pieces of material within the seminal vesicles.
Seminal vesicle calculi are rare and have been mainly reported after the age of 40 years 1.
Seminal vesicle calculi are often associated with haematospermia....
Seminal vesicle amyloidosis refers to the deposition of amyloid in the seminal vesicles and can occur as organ-limited amyloidosis and/or as part of systemic amyloidosis.
Amyloid deposition in the seminal vesicles is apparently commonly seen in elderly men with a prevalence rangin...
Prostatic acid phosphatase (PAP) also known as prostatic specific acid phosphatase (PSAP) is an enzyme generated by prostatic glandular tissue.
It can be used in immunohistochemistry to identify prostatic tissue including prostatic epithelium and prostatic ducts and is usually expressed ...
Mucinous adenocarcinomas of the prostate or colloid adenocarcinomas of the prostate are a variant of acinar adenocarcinoma and characterised by mucinous features.
Mucinous adenocarcinomas of the prostate are rare and account for less than 0.5% of prostate cancers 1-4.
Adenocarcinomas of the seminal vesicles are the most common malignant primary neoplasm of the seminal vesicles.
Primary adenocarcinomas of the seminal vesicles are very rare 1,2 and can be observed at a wide age range 2.
The following modified diag...
Basal cell carcinoma of the prostate or prostatic adenoid basal proliferation of uncertain significance is a type of prostate cancer resembling adenoid cystic carcinoma of the salivary glands.
Other terms include 'adenoid cystic carcinoma', 'adenoid basal cell tumour', 'adenoid cys...
Squamous neoplasms of the prostate include squamous cell carcinomas and adenosquamous carcinomas of the prostate that account for two separate entities in the WHO classification of prostate tumours.
Squamous cell carcinomas of the prostate are very rare and encompass <1% of prosta...
Urothelial carcinomas or transitional cell carcinomas of the prostate are malignant neoplasms that can occur as primary cancers of the prostate gland.
Prostatic urothelial carcinomas account for less than 2-4% of all prostate cancers 1 and are usually seen in middle-aged men 2.
The viscera (singular: viscus) refers to all the internal organs within the major cavities of the thorax, abdomen and pelvis. Therefore it does not include organs of the CNS, head and neck or musculoskeletal compartments nor does it encompass non-internal organs (e.g. the skin) 1.
High-grade prostatic intraepithelial neoplasia (HGPIN) refers to a proliferation of glandular epithelial cells and is generally considered a nonobligatory precursor lesion of invasive prostate cancer.
High-grade prostatic intraepithelial neoplasia is diagnosed in core needle biops...
Intraductal carcinomas of the prostate (IDCP) are a new subtype of prostate cancer that has been included as a new entity in the WHO classification of prostate tumours in 2016.
Intraductal carcinomas of the prostate are rarely found isolated on needle core biopsy samples in 0.1-0....