Replies to This Discussion

Permalink Reply by Carolyn DeLeo on February 23, 2011 at 11:01am

Jessica: Endovaginal imaging is a great way to image ureteral stones. Having it be an incidental finding would not be common. Typically the patient would be symptomatic. A differential would be arterial calcification.

Permalink Reply by Lisa Comer on September 25, 2011 at 7:04pm

I have seen distal ureteral calculi often; in fact, you can normally identify the UVJ with a partially full urinary bladder on everyone. The key is to not over distend the bladder.  You may see ureteral peristalsis if the pt is well hydrated. The distal ureters lie obliquely in the pelvis, posterior and lateral to the bladder, with only a few cms being visualized.  Mag your image and optimize with good contrast resolution.  Stones often get hung up at the UVJ and the portion of the ureter superior to the stone will be slightly dilated; turn on color doppler aimed at the UVJ and you will actually see ureteral jetting when there is partial or no obstruction. When you get really good at identifying them, your urologist will become your friend. There should be no confusion as you connect the ureter to the bladder. Begin to find the UVJ with transverse and inferior imaging of the bladder, then rotate to lengthen out the ureter; compare with the ipsilateral side. Stones will usually exhibit posterior shadowing.  Good Luck.