What is the top differential?
In the setting of trauma, adrenal gland haematoma would be at the top of the list.
What recommendations would you make to the referrer?
Either prior imaging should be reviewed (if available) to ensure this is not a pre-existing lesion. If no prior imaging, a suspected isolated adrenal gland injury requires follow-up imaging to ensure resolution and this is not a malignant lesion.
Soft tissue density (mean HU = 48) lesion of the right adrenal gland measures 3.7 cm (ap) X 2.2 cm (trans) X 3.5cm (craniocaudally). It is associated with some ill-defined perinephric opacity at the upper pole of the right kidney.
Liver, gallbladder, spleen and pancreas are of unremarkable appearance. Left adrenal gland unremarkable. Simple renal cysts.
No pneumoperitoneum. No free fluid.
Acute fractures of the right L1-L3 transverse processes, minimally displaced.
Conclusions:
Right adrenal lesion, in the setting of trauma probably represents a haematoma. Comparison with any prior imaging required or if not available follow-up CT recommended.