case write-up radiology 4

Identification Data

Name : Noor Badrul Hisham Bin Noor Shah

Age     : 50 years old

Race   : Malay

X-Ray  No : 2305

Type of Imaging : Intravenous Urography

Positioning : Supine

Clinical History

Patient is a known case of dyslipidemia diagnosed  15 years ago. He complaints of having left loin to groin pain. The pain was dull in nature and he described it as very severe because he had to roll around the bed to relieve it. There were no hematuria, or passing out stone during micturition. Intravenous urography was done to rule stone and other urinary tract pathology.

 Patient Preparation

        i.            No food for 5 hour prior to the examination.

      ii.            Patient should, preferably be ambulant for 2 hour prior to examination to reduce bowel gas.

    iii.            If patient has allergy to contrast medium, consideration  should be given to administer methyl prednisolone orally 12 and 2 hour prior to injection of contrast medium.

Procedure

        i.            Preliminary film taken in supine,full length AP position of the abdomen,in inspiration to make sure adequate bowel preparation and to rule out any urinary calculi.

      ii.            Patient is given Intravenous bolus infusion of contrast media which is Iopamiro 300.

    iii.            5 minute film taken to determine if excretion is symmetrical and is invaluable for assessing the need to modify technique.

   iv.            15-minute film to demonstrate pelvicalyceal system.

     v.            Release film is taken to show whole urinary tract.

   vi.            Post micturition film to assess bladder emptying and to demonstrate return to normal of dilated upper tracts with relief of bladder pressure.

Findings

        i.            Preliminary film: There is faceted radiopacity seen on the left L1 and L2 vertebral level measuring 3 cm and 1 cm.

      ii.            Post Contrast :

·        Both kidneys are normal in shape, size and position.

·        Bipolar length  of Right kidney measures 12.0 cm while left kidney measures 15.5 cm.

·        No hydronephrosis  or hydroureter  seen

·        Normal configuration of urinary bladder.

·        Persistent clubbing seen within the left lower calyx is consistent with the opacity seen in preliminary film.

    iii.            Post micturition : No contrast hold up and no significant residual volume seen in urinary bladder.

Impression

Left renal calculus with no evidence of obstructive uropathy

case write-up radiology 3

                                              

Identification Data

Name : Rajamah a/p komara

Age     :  63 years old

Race   :  Indian

Date   :  8 February 2011

X-Ray No : 1209

Type of Imaging : Ultrasound study of abdomen

Positioning : supine

Clinical History

Patient is a known case of chronic liver disease with oesophageal varices diagnosed 2 years ago. Ultrasound of abdomen was done for yearly monitoring of her condition. She does not have any sign and symptoms suggesting portal hypertension.

Procedure

Patient lying on supine position,longitudinal scans from epigastrium or left subcostal region across to right subcostal region.Transverse scans,subcostally to visualise the whole liver.

Findings

Liver is irregular in surface with coarse echotexture.No focal lesion noted.No gallstones noted.Both kidney are normal in echogenicity. No stones noted.Spleen is enlarged.

Impression : Liver cirrhosis with splenomegaly

case write-up radiology 2

Identification Data

Name : Wong Kow

Age     : 62 years old

Race   : Chinese

Date   : 8 February 2011

X-Ray No : 7315

Type of Imaging : Intravenous Urography

Positioning : Supine and prone

Clinical History

Patient is a known case of hypertension, benign prostate hypertrophy and compliant to medication. He was referred to radiology department for assessments of delineation of urinary tract. He was complaining of having nocturia 5 times in one night,increase frequency of micturition and also incomplete voiding. He does not complain of having pain during micturition and passing out blood or stone.

Patient Preparation

        i.            No food for 5 hour prior to the examination.

      ii.            Patient should, preferably be ambulant for 2 hour prior to examination to reduce bowel gas.

    iii.            If patient has allergy to contrast medium, consideration  should be given to administer methyl prednisolone orally 12 and 2 hour prior to injection of contrast medium.

Procedure

        i.            Preliminary film taken in supine,full length AP position of the abdomen,in inspiration to make sure adequate bowel preparation and to rule out any urinary calculi.

      ii.            Patient is given Intravenous bolus infusion of contrast media which is Iopamiro 300.

    iii.            5 minute film taken to determine if excretion is symmetrical and is invaluable for assessing the need to modify technique.

   iv.            15-minute film to demonstrate pelvicalyceal system.

     v.            Release film is taken to show whole urinary tract.

   vi.            Post micturition film to assess bladder emptying and to demonstrate return to normal of dilated upper tracts with relief of bladder pressure.

Findings

        i.            Preliminary film: No radiopacity seen along urinary tract

      ii.            Post Contrast :

·        Both kidneys are normal in shape, size and position.

·        Bipolar length  ofRight kidney measures 13.0 cm while left kidney measures 14.5 cm.

·        Left mild hydronephrosis to the distal hydroureter is seen

·        There are also strictures in left distal ureter. Beyond this, ureter is normal.

·        Right pelvicaliceal system and ureter are normal.

·        There is outpouching from the bladder wall in the left side.

·        Both kidneys showed normal contrast excretion.

    iii.            Post micturition : minimal residual urine in the bladder. No hold up of contrast.

Impression

Left mild hydronephrosis and hydroureter due to stricture or recent passing out of calculi in the distal ureter.

Bladder diverticula.

case write-up radiology 1

                                          
Identification Data

Name:  Abdul Aziz Bin Mohamed

Age    :  52 years old

Race  :  Malay

Date of admission : 7 February 2011

X-Ray No : 1159

Type of Imaging : Ultrasound study of Genitourinary System

Positioning : Supine

Clinical History

Patient is a known case of Diabetes mellitus and hypertension, was admitted with chief complaint of vomiting and diarrhoea for two days duration associated colicky abdominal pain, lethargy and dizziness.

Procedure

Patient lying on supine position, kidneys are scanned longitudinally and transversely. The right kidney is scanned through the liver and posteriorly in the right loin. The left kidney is visualize from the left loin.

Findings

Kidney	Bipolar Length          (mm)	Echogenicity	Hydronephrosis
Left	90	increased	nil
Right	86	increased	nil

Impression : Chronic Renal Parenchymal Disease