{"id":389,"date":"2018-07-01t12:31:25","date_gmt":"2018-07-01t12:31:25","guid":{"rendered":"\/\/www.iolishoes.com\/?page_id=389"},"modified":"2021-06-28t22:57:28","modified_gmt":"2021-06-28t12:57:28","slug":"paediatric-renal-normal","status":"publish","type":"page","link":"\/\/www.iolishoes.com\/paediatric-renal-normal\/","title":{"rendered":"paediatric renal normal"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"389\" class=\"elementor elementor-389\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-13721bf elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"13721bf\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-756e176\" data-id=\"756e176\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-602cd3fa elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"602cd3fa\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2c14b1fc\" data-id=\"2c14b1fc\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-137d1dc1 elementor-widget elementor-widget-heading\" data-id=\"137d1dc1\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"background\"><\/span>background<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4079944 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4079944\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3886488\" data-id=\"3886488\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9c9e3fc elementor-widget elementor-widget-text-editor\" data-id=\"9c9e3fc\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>the normal ultrasound appearances of the kidney vary with age.<\/li><li>initially, in the neonatal period, there is almost no medullary fat.<\/li><li>the pyramids are visibly prominent and hypoechoic. they span almost the entire cortex.be cautious not to mistake them in the neonate as prominence of the collecting system.<\/li><li>beyond 1 year old the kidneys take on a more typical appearance with better differentiation between medulla and cortex and less prominent pyramids. depending on the habitus of the child, there will still be minimal echogenic medullary fat.<\/li><li>in both the neonatal and paediatric kidney, the foetal cortical lobulations are pronounced and should span the pyramids (as seen in the images below). if a lobulation dips into a pyramid, it is likely to be a cortical scar.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-77048ba9 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"77048ba9\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-22f6e911\" data-id=\"22f6e911\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7dff514a elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"7dff514a\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-20f25e3c elementor-widget elementor-widget-text-editor\" data-id=\"20f25e3c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>a neonatal kidney ultrasound.<\/p><p>this kidney has a distended collecting system secondary to a puj<\/p><p>performed with a 12mhz linear array probe.<\/p><p>note the abscence of medullary fat.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-2a4633d3\" data-id=\"2a4633d3\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2913dbfa elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"2913dbfa\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-445f7d04 elementor-widget elementor-widget-text-editor\" data-id=\"445f7d04\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>a normal neonatal kidney ultrasound.<\/p><p>note the prominant pyramids and cortical lobulations spanning them<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-451e6504 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"451e6504\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-1a037f74\" data-id=\"1a037f74\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4224214e elementor-align-left elementor-widget elementor-widget-button\" data-id=\"4224214e\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-grow\" href=\"https:\/\/radiology-universe.org\/calculator\/pediatric-kidney-sizes\/calculator.php\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-bookmark\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">reference article<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-241feba7\" data-id=\"241feba7\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4c91f629 elementor-widget elementor-widget-text-editor\" data-id=\"4c91f629\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p style=\"text-align: left;\"><a href=\"https:\/\/radiology-universe.org\/calculator\/pediatric-kidney-sizes\/calculator.php\">pediatric kidney size calculator<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1819735 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1819735\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0026efe\" data-id=\"0026efe\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-da3da38 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"da3da38\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-672f5bfc elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"672f5bfc\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-22aee0ee\" data-id=\"22aee0ee\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-75631dd elementor-widget elementor-widget-text-editor\" data-id=\"75631dd\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h1 style=\"text-align: center;\">scan protocol<\/h1>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4a06219b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4a06219b\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1172bfda\" data-id=\"1172bfda\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6c153fe2 elementor-widget elementor-widget-text-editor\" data-id=\"6c153fe2\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"role_of_ultrasound\"><\/span>role of ultrasound<span class=\"ez-toc-section-end\"><\/span><\/h3><ul><li>confirm normal anatomical position of kidneys<\/li><li>exclude structural anomalies.<\/li><li>assess size of the kidneys and collecting systems<\/li><li>exclude renal cortical scarring.<\/li><li>exclude renal or suprarenal masses (cystic or solid)<\/li><li>assess bladder filling and emptying<\/li><li>confirm bilateral symmetrical ureteric jets into the urinary bladder.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-229e715e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"229e715e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-799cdfd8\" data-id=\"799cdfd8\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-60a4038a elementor-widget elementor-widget-text-editor\" data-id=\"60a4038a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"limitations\"><\/span>limitations<span class=\"ez-toc-section-end\"><\/span><\/h3><p>co-operation is the biggest challenge with any paediatric study.<\/p><p>if scanning a neonate, try to time the scan after a feed for best compliance.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2c587a00 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2c587a00\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2d2ce8d0\" data-id=\"2d2ce8d0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-27833f13 elementor-widget elementor-widget-text-editor\" data-id=\"27833f13\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"patient_preparation\"><\/span>patient preparation<span class=\"ez-toc-section-end\"><\/span><\/h3><p>this will vary.<\/p><p>supine is needed to assess the bladder.<\/p><p>often allowing the parent or care-giver to nurse the child provides better cooperation. scanning the kidneys from postero-laterally whilst a toddler cuddles the parent provides a good acoustic window.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7709c28b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7709c28b\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7b5a08be\" data-id=\"7b5a08be\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3f2e2753 elementor-widget elementor-widget-text-editor\" data-id=\"3f2e2753\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"equipment_setup\"><\/span>equipment setup<span class=\"ez-toc-section-end\"><\/span><\/h3><p>5+mhz curvilinear probe<\/p><p>12mhz linear probe<\/p><p>warm gel<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-76c54af8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"76c54af8\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2743665\" data-id=\"2743665\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2aa1705a elementor-widget elementor-widget-text-editor\" data-id=\"2aa1705a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"common_pathology\"><\/span>common pathology<span class=\"ez-toc-section-end\"><\/span><\/h3><p>neonatal and paediatric renal pathology can be broadly grouped into:<\/p><ul><li><strong>fusion anomalies<\/strong>. (horseshoe, ectopia, cross-fusion)<\/li><li><strong>hypoplasia or agenesis<\/strong>.<\/li><li><strong>duplication anomalies<\/strong>. (supernumerary or variants of the collecting system and uterers)<\/li><li><strong>congenital structural disease<\/strong>\u00a0(juveline pckd, mcdk, dysplasia)<\/li><li><strong>solid tumour<\/strong>. (wilms,mesobalstic nephroma, nephrobasomatosis, rhabdoid)<\/li><\/ul><div><strong>*** ultrasound\u00a0cannot\u00a0exclude vesico-ureteric reflux ***<\/strong><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-19742be6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"19742be6\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9ca6842\" data-id=\"9ca6842\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-fec8ae3 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"fec8ae3\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7d632889 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7d632889\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-50fb0711\" data-id=\"50fb0711\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4122087a elementor-widget elementor-widget-text-editor\" data-id=\"4122087a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h1 style=\"text-align: center;\">scanning technique<\/h1>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-77000861 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"77000861\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-319f0a9b\" data-id=\"319f0a9b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-42cfaf7f elementor-widget elementor-widget-text-editor\" data-id=\"42cfaf7f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2><span class=\"ez-toc-section\" id=\"kidney\"><\/span>kidney<span class=\"ez-toc-section-end\"><\/span><\/h2><p>\u00a0<strong>using a curvil-inear probe:<\/strong><\/p><ul><li>assess the kidneys in both longitudinal and transverse sections from the flank. because the lower ribs are not densely ossified, you can use an &#8216;intercostal approach.<\/li><li>ensure you sweep entirely through the kidneys in both planes, particularly beyond the upper pole to exclude adrenal pathology. this may be best achieved more cranially, using the liver as an acoustic window.<\/li><li>be cautious of over-calling hydronephrosis if in a coronal plane. the calyces may be very obvious but still normal if approached from the coronally. confirm calycael dilatation also in the transverse\/axial plane.<\/li><li>obtain an accurate length measurement of each kidney, reproduced at least twice.<\/li><\/ul><p><strong>using a higher frequency(10-12mhz) \u00a0linear probe:<\/strong><\/p><ul><li>reassess the kidneys with a focus on the cortex and medullary pyramids.<\/li><li>look for cortical scarring. this will be evident as linear echogenic line from the cortical edge in towards a pyramid. do not confuse normal lobulations which will span the pyramids.<\/li><li>look at the echogenicity of the pyramids. they should be hypoechoic. any increased echogenicity is suggestive of a nephritis. if the pyramids have echogenic lines throughout, this is likely severe pyelonephritis<\/li><\/ul><h2><span class=\"ez-toc-section\" id=\"bladder\"><\/span>bladder<span class=\"ez-toc-section-end\"><\/span><\/h2><ul><li>begin in transverse with a slight caudal angle. sweep trough the bladder for any structural defects or focal wall thickening.<\/li><li>apply colour\/power doppler to look for ureteric jets. this may require patience. confirm there are 2 and they are reasonably symmetrical with no residual distal ureteric dilatation or ureteroceles.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7d75ec5c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7d75ec5c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7728ef71\" data-id=\"7728ef71\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-418122c5 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"418122c5\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-17295506 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"17295506\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3df38c52\" data-id=\"3df38c52\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4cc2c9a2 elementor-widget elementor-widget-text-editor\" data-id=\"4cc2c9a2\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"basic_hardcopy_imaging\"><\/span>basic hardcopy imaging<span class=\"ez-toc-section-end\"><\/span><\/h3><p><strong>kidneys:<\/strong><\/p><ul><li>longitudinal and transverse. with curved probe and linear array if possible<\/li><li>length measurement of the kidney<\/li><li>transverse measurement of the renal pelvis<\/li><\/ul><p><strong>urinary bladder:<\/strong><\/p><ul><li>longitudinal and transverse images<\/li><li>image showing the ureteric jets with colour doppler if possible (this requires patience)<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>background the normal ultrasound appearances of the kidney vary with age. initially, in the neonatal period, there is almost no medullary fat. the pyramids are visibly prominent and hypoechoic. they span almost the entire cortex.be cautious not to mistake them in the neonate as prominence of the collecting system. beyond 1 year old the kidneys [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"tags":[],"class_list":["post-389","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages\/389","targethints":{"allow":["get"]}}],"collection":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/comments?post=389"}],"version-history":[{"count":0,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages\/389\/revisions"}],"wp:attachment":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/media?parent=389"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/tags?post=389"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}