Rolling stone sign in bladder calculus

Case contributed by Subash Thapa


Suprapubic pain

Patient Data

Age: 30 Years
Gender: Male

There is a focal echogenic structure with posterior acoustic shadow in the left vesicoureteric junction area. The echogenic structure rolls along the inner bladder wall to the dependent portion, when changing the position of the patient.

Case Discussion

Ultrasonography is the most sensitive tool for the diagnosis of a bladder calculus when the size is >3 mm 1.

Stones appears as echogenic structure that cast posterior acoustic shadows.

Sometimes a calculus in the vesicoureteric junction may be difficult to diagnose from a bladder calculus. In such cases, changing the position of the patient is mandatory. If the calculus rolls along the inner wall of the bladder to the dependent portion, this has been referred to as the “rolling stone sign” which is suggestive of bladder calculus.

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