Vesicoureteric junction calculus - value of twinkling artifact
Severe right groin pain
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An obstructing 4 mm calculus noted in right ureterovesical junction causing mild hydroureteronephrosis proximal to it. Note nice demonstration of twinkling artifact.
Twinkling artifact is the consequence of intrinsic machine noise seen with color Doppler ultrasound. It happens as a focus of alternating colors on Doppler signal behind a reflective object (such as calculi), which gives the appearance of turbulent blood flow. It occurs with or without an associated color comet-tail artifact.