please help translate my ultrasound report

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

upjo
Regular Member


Date Joined Jul 2014
Total Posts : 98
   Posted 9/22/2014 4:44 PM (GMT -6)   
I have posted here about persistent right side abdominal and flank pain after my laparscopic kidney surgery to fix a narrow ureter near kidney. Since then all my reports were coming ok with no explaination for pain until today when I got report for a recent ultrasound. I hope someone can translate it for me until I see a specialist.

It reads : The right kidney measures 9.4 cm, the left kidney measures 10.9 cm in length. There is a bright echogenic focus within the right renal upper pole measuring 5 mm with an absence of posterior shadowing. No hydronephrosis bilaterally. Visualized portions of the abdominal aorta are of normal caliber. Provided spot images of the right and left lower quadrants are unremarkable. Images at the surgical incision site of the right flank/ upper quadrant demonstrates a hypoechoic area
measuring 0.9 x 0.3 x 1.2 cm.

Opinion:
1) Nonspecific brightly echogenic 5mm focus of the right renal upper pole. Considerations include a nonobstructive non posterior shadowing renal calculus, arcuate artery, or milk of calcium. Further characterization with CT may be obtained if needed for patient management.

2) Small hypoechoic area of the superficial subcutaneous soft tissues in the region of the surgical incision site at the right upper quadrant/ flank, nonspecfic. This can be correlated at the time of CT or with follow up ultrasound. No abcess formation.

Can someone tell me which of these two things has been causing this constant flank pain? I had two ultrasounds and one ct a month and half ago, they all came back normal even though I had the same pain back then.

Merrida
Forum Moderator


Date Joined Jul 2013
Total Posts : 4771
   Posted 9/22/2014 6:08 PM (GMT -6)   
Please understand that no one here is dismissing you or your request for help. It's important to understand that we are not medical professionals, collectively speaking. Even the members we do have that are, this isn't a medical advice board. It's a support forum, and that's the capacity in which we can act.

The best person to ask about these results is going to be your doctor. I would think that whoever ordered the tests would at least be able to provide you with a basic understanding of what's going on, and then the specialist will fine-tune that information as it applies to you!





M.
Moderator Anxiety/Panic Forum


"My time for tears will be at my Victory...not at the start of the War." ~~Vickie

sharinghelps
New Member


Date Joined Sep 2014
Total Posts : 8
   Posted 9/22/2014 6:09 PM (GMT -6)   
Hi.
First, I absolutely cannot tell you what's causing your pain. That's for you and your doctor to sort out. Sorry for that.

I can tell you that " echogenic focus" just refers to a white spot on the scan. As with most scans, a white area is denser than the surrounding tissues/organs. That's why bones show white on X - rays.

So you have some dense areas on or in your kidney. My understanding is that these areas can be stones (the calculi in the report) or just areas of fat deposits or other dense tissues.

I don't see anything on the report that indicates a theory as to what is causing the white spots. Has your doc suggested any other tests? Some of than can be more sensitive with regard to what is causing the spots.

Make sure you keep telling your doc that the pain is continuing! As a kidney stone sufferer myself, I know that lots of things can cause lots of different types of flank and/or kidney pain.
Hang in there!

upjo
Regular Member


Date Joined Jul 2014
Total Posts : 98
   Posted 9/22/2014 7:19 PM (GMT -6)   
Thanks for replies. Well I am going to try and get in to see one of many urologists I was seeking 2nd opinion from. Thing is they all pretty much dismissed my pain because nothing was showing up on any test for 5 months even though my pain has been 24/7 everyday. I saw a pain doc couple of weeks ago who thought I was having abdominal wall pain from surgical incision ( I think that's what the 2nd part of this report is mentioning). He gave me nerve block with local and steroid which helped temporarily with abdominal pain but nothing for flank pain( maybe because he didn't inject it in flank). But now this report is also mentioning something in my kidney so now I dont know which problem is causing this pain or if it's both.

I don't want to wait for these doctors appointments and then have to wait for ct scans etc. I made this mistake for 5 months. I am just planning to go ER and fake lot of pain so they can do a ct scan right there. I am just getting sick of this constant pain. I am seeinga neurologist in 2 days and then pain doctor after that, I hope someone can end this suffering for me. Thanks for replying though.

sharinghelps
New Member


Date Joined Sep 2014
Total Posts : 8
   Posted 9/22/2014 7:35 PM (GMT -6)   
Oh no!
Please rethink that strategy! "Faking pain?

ER staff are well trained to recognize this. They are also generally trained to a avoid expensive tests from the ER if at all possible.

If you do this, you will risk all of the trust your docs may have in you. They will not want to listen to you, may not want to treat you, and will likely not prescribe for you - ever again.

It's not worth risking future help if you can possibly wait. Keep calling your doc, see if you can get on a cancelation list for an appointment sooner. But please don't ever fake symptoms. It's hard enough to be believed in the first place!

poplargrove
Regular Member


Date Joined May 2014
Total Posts : 120
   Posted 9/22/2014 9:47 PM (GMT -6)   
Yep, what sharinghelps said!

I have a daughter who is a nurse practitioner, and a son who is a paramedic.

Believe it, they KNOW if you are faking pain. You should hear the "shop talk" conversations around our dinner table when everybody's home. Your vital signs, plus lots of things you have no idea they're looking at will tell them the truth for what's going on with your body!

It sure sounds like you are on the right track here, don't abandon the horse race in the home stretch! (You get the gist)!!

I have had lots and lots of kidney issues throughout my life, and kidney pain will bring you to your knees. Please try to keep up the VALUABLE trust you have with your docs! You will probably be glad you did. Just sayin'....... :). Good luck
ACDF 5/6 2004, ACDF 6/7 2005, Shoulder arthroscopy 2006, posterior disc decompressions and laminectomies 08/21/2014. dx'd with MS 2002. mom of 6 kids: 5 humans, and one canine!

upjo
Regular Member


Date Joined Jul 2014
Total Posts : 98
   Posted 9/22/2014 10:22 PM (GMT -6)   
Thanks for the advice. Maybe I used the wrong word because the thing is I am already in pain, it's constantly at 5-6 all the time. I just have to say that past couple of days it has become unbearable and with ultrasound report showing two abnormalities, they might order ct for me. Especially since I am running out of pain meds and family doctor wont prescribe, ER is my only hope until I see a specialist. Thanks everybody though

nvrthesame98
Forum Moderator


Date Joined Jun 2008
Total Posts : 6706
   Posted 9/23/2014 5:28 AM (GMT -6)   
Up, first as others said we are not Dr's and CT may or may not help your cause. One Er's especially during nights, holidays, weekends may call in a tech to do the scan but they are not going to call a radiologist to read it. That means your going to be depending on a ER Dr to look at it who's not likely to be able to tell you anymore then you already know and the film still won't be officially read until the radiologist reads it. That being said you have an appointment in two days and I know when your in pain that can seem like years but it will tell you more.

Now if the pain increases, changes drastically, moves to different location, blood in urine, fever developes those are things that need immediate attention.

As for the US those shadows usually indicate another stone, scar tissue in incision line,,, and that one's more eye catching then the actual one in the kidney. Did sutures not dissolve? Some fistula or pocket developed? So either or both could be causing the pain and personally I would want a specialist versus a ER Dr looking to decided what they are and what should come next. IVP maybe to get a better picture of the kidney thing to be certain it's not effecting the flow of urine or blocking blood flow.

Hang in there your finally getting some kinda answer's even if they're not coming as fast as you would like, better to get this right the first go round.
Vickie
CHRONIC PAIN MODERATOR


Knowing when to walk away is WISDOM
Being able to is COURAGE

Backtolife
Veteran Member


Date Joined Aug 2014
Total Posts : 819
   Posted 9/23/2014 5:36 AM (GMT -6)   
When my pain becomes worse, moves to a different place, changes in type, or comes with additional symptoms like weakness (I get so weak sometimes I can only take a couple of steps without having to sit down), on the weekends I used to go to the ER, but as a patient in pain management they won't do anything. I have told them over and over that I'm not wanting them to do anything for the pain, just check and see if something 'new' is wrong, but they don't seem to get that. The few experiences I've had in the ER since being in a PM program is that they give me Toradol. I seriously, seriously wish that drug could be taken at home because it helps me FAR more than any narcotic med I've ever taken. One shot of that stuff and I'm almost pain free for an entire day.

There have been a few times when I asked for a CT scan because I was SURE they'd find something, but doctors don't listen and make their own decisions (usually for good reasons, I believe). My last CT was two months ago and there was a cyst that had grown significantly since the previous CT, but I still can't seem to get someone to send me for another CT, so I think they want to wait a while.

Also, ER docs will only prescribe a very small amount of meds, if any at all, and your doctor won't appreciate it (if s/he is worth their salt). ER is a very bad idea for refills of meds. If you aren't already in a pain management program (sounds like you're not), I suggest that as the best way of managing meds. PM docs look at pain and treating pain, not necessarily treating the cause - although they will help you find the cause if you don't know what it is.

PG, out of curiosity, which vitals do they look at? I have very low blood pressure usually (90/60 on average). So elevated for me is anything over 100 in the systolic number.

Good luck!

Post Edited (Backtolife) : 9/23/2014 5:41:59 AM (GMT-6)


nvrthesame98
Forum Moderator


Date Joined Jun 2008
Total Posts : 6706
   Posted 9/23/2014 8:56 AM (GMT -6)   
Btl , Toradol actually has a oral form that can be taken at home but not at high doses or longer then 5days. It's sold as ketrolac, sp?,. The thing with toradol is it has a much higher potential for GI bleed, perforation of the stomach, and at fatal incidents without warning. The older and more debilitated the person the higher the incident o of fatality. Thus the benefit really has to outweigh the riskand most of us are on other meds that would only increase our risk and that's why you rarely see it presenter prescribed other than shot inpatient. Too bad they can't figure out how to lessen that risk because like you I think It's an awesome anti inflammatory med working so much faster then It's counter parts.
Vickie
CHRONIC PAIN MODERATOR


Knowing when to walk away is WISDOM
Being able to is COURAGE

Dixie6
Veteran Member


Date Joined Aug 2014
Total Posts : 1022
   Posted 9/23/2014 11:23 AM (GMT -6)   
Hey UpJo...You've gotten excellent advice.   I can only chime in with my experience.  I was having similar problems due to a prolonged UTI.  My PCP was not aggressive in treating it for over a year (yep...Bactrim doesn't work for me, but he doesn't listen)  I was in debilitating pain in my flanks.  I thought my kidneys were shutting down, as I would literally "howl" when I moved=(  I went to the ER where they only did a standard UA which looked clear.  I asked them to culture where I KNEW it would show up because of bladder adhesion issues.  Although I knew the culture would take several days, I BEGGED them to do an IV push of Rocephin.  The ER doctor told me that it would be "malpractice to treat an illness with no proof".  W-H-A-T?  I ended up in the ER a second time within a week, writhing in pain with my husband again at my side.  The ER doctor (different) found severe infection in culture threatening my kidneys.  He would NOT do the Rocephin IV push, but put me on 500 mg Levaquin and insisted I "chew" (yuk) them for faster absorption for 30 days.
 
ALL of that to say this...The ER in my opinion, is a waste of time and money for diagnostic issues.  Don't take that route unless, as NTS says, if you have blood in urine, etc.  I UNDERSTAND your fear, as I have a pelvic kidney and both kidneys and bladder are enshrouded by adhesions.  However, if your appointment with urologist is within the next 2 days, HANG IN THERE until you see him.
 
HUGS~~Dixie
Stage 4 Endometriosis
Radical Hysterectomy w/Ovaries removed in 1993-94
Debilitating Pelvic, Vaginal and Rectal Pain
IBS w/constipation, Diverticulosis
Herniated Cervical and Lumbar Discs w/Nerve Compression
Arthritis, Osteoarthritis (Severe Bone Loss), DDD, Sciatica
Depression, Anxiety

upjo
Regular Member


Date Joined Jul 2014
Total Posts : 98
   Posted 9/23/2014 3:55 PM (GMT -6)   
Sorry my appointment is with a neurologist since all my urologists were telling me everything is normal with kidney and it might be nerve related pain from surgery. So that's why I made appointment with a neurologist and now something kidney related showed up. I will see what this doctor thinks, maybe some sort of permanant block for this pain regardless of whatever the heck is going on with kidney, I wouldn't care as long as something gets rid of this pain. Maybe he can order ct or mri.
I have made appointment with a urologist for next week so let's see. It's the same doctor who botched my surgery and put me in this mess but he's the earliest I can see.
My biggest problem is pain control because I dont find anything to help with pain. Ketoralac doesnt work for me at all, nerve pills don't work for me, percocet helps but not much, only thing works so far is hydromorphone but I have to take it too much for any doctor to be comfortable in prescribing regularly.


Thanks for all the advice, I will try to get ct through specialist. Nvrthesame you mentioned something about radiologist not reading the ct films in ER etc, I guess that makes sense since one of my friends went to ER with like the worst possible headaches and they did ct and said he has brain aneurysm and will need brain surgery but then the next day they changed diagnosis to migraines

nvrthesame98
Forum Moderator


Date Joined Jun 2008
Total Posts : 6706
   Posted 9/23/2014 4:27 PM (GMT -6)   
Now that is one misreading I would not want to have happen!! ER Dr's are not trained extensively in pathology, they study anatomy at great lengths and depth so know what normal looks like,,, can detect abnormal even but when it comes down to just exactly what is that abnormality they're not broadly versed. That special training belongs to Radiology. That's what they do, all they do basically and you wouldn't want a radiologist coding you no more then you want to depend on a trauma dr deciding if you are changes to the brain indicative of a migraine versus a tumor. Just as someone with prostrate cancer wouldn't be best treated by an obstetrician. All Dr's are not created equal after a certain point in their education and a radiologist is a Dr who specializes in his field just as the others are.

I hate to be the party pooper here but that Neurologist isn't likely to render any type of blocks without knowing what that is in the kidney. Mainly because if it is a stone and It takes a notion to move it could very well block the urinary system at some point along the way causing irreversible damage and your pain signals would Possibly be diminished to where you wouldn't realize it until It's done. You could lose a kidney or both.

I would try getting into urology inlight of the new findings before next week and preferably with someone impartial not the one who did the procedure.
Vickie
CHRONIC PAIN MODERATOR


Knowing when to walk away is WISDOM
Being able to is COURAGE

Dixie6
Veteran Member


Date Joined Aug 2014
Total Posts : 1022
   Posted 9/23/2014 5:37 PM (GMT -6)   
I agree with NTS on the neurologist.  I thought you were seeing a urologist this week.  PLEASE don't GO BACK to a doctor who "botched your last surgery".  It sounds as though you are in a bind, with multiple issues.  I think the best you can hope for through the neurologist is yet another referral.  Please don't allow your desperation for pain relief to cloud your good judgment...though I understand the proverbial "don't know which way to turn".  Been there, been back there...wish I hadn't done that.
 
Hugs~~Dixie
Stage 4 Endometriosis
Radical Hysterectomy w/Ovaries removed in 1993-94
Debilitating Pelvic, Vaginal and Rectal Pain
IBS w/constipation, Diverticulosis
Herniated Cervical and Lumbar Discs w/Nerve Compression
Arthritis, Osteoarthritis (Severe Bone Loss), DDD, Sciatica
Depression, Anxiety
New Topic Post Reply Printable Version
Forum Information
Currently it is Monday, October 23, 2017 12:35 AM (GMT -6)
There are a total of 2,885,883 posts in 316,652 threads.
View Active Threads


Who's Online
This forum has 157753 registered members. Please welcome our newest member, Gghjg0258.
275 Guest(s), 2 Registered Member(s) are currently online.  Details
07kr5, sebreg


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest
Advertisement
Advertisement

©1996-2017 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer