Nephrolithiasis on ultrasound with comet-tail artefact
Non specific flank pain. Limited history due patient's confusion
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Right hydronephrosis and calculus in right VUJ, demonstrating comet tail artefact.
No left hydronephrosis (incidental renal cyst). Left ureteric jet present (i.e. left ureter not obstructed).
The diagnosis of urolithiasis is rarely made with ultrasound wherever CT is available, due to the relatively high sensitivity of the clinical presentation in directing investigation, and the high sensitivity of CT in confirming the diagnosis.
In this case however ultrasound was performed, and showed very nicely the features, namely the obstructing calculus at the right vesicoureteric junction with Doppler comet-tail artefact, right hydronephrosis and absence of right ureteric jet.