Hepatobiliary Ultrasound
Gallbladder ultrasound is the first-line study for right upper quadrant pain. Sonographic Murphy sign combined with gallstones has high positive predictive value for acute cholecystitis. RadCall covers the full diagnostic criteria, gangrenous cholecystitis features, and HIDA scan indications when ultrasound is equivocal.
- Acute cholecystitis — stones, wall thickening, Murphy sign
- Sonographic Murphy sign — direct probe tenderness over GB
- Wall thickening — >3 mm criteria, non-specific causes
- Gangrenous cholecystitis — asymmetric thickening, sloughed mucosa
- Pericholecystic fluid — free fluid, perforation risk
- Common bile duct — dilation threshold by age
- Choledocholithiasis — stone, shadowing, CBD diameter
- Mirizzi syndrome — extrinsic CBD compression by stone
Vascular Ultrasound — DVT
Lower extremity venous duplex for DVT uses compression ultrasonography as the primary technique. Non-compressibility is the diagnostic criterion. RadCall covers proximal vs distal DVT, the two-point vs whole-leg protocol, and IVC thrombosis evaluation.
- Compression US — non-compressibility = DVT
- Proximal DVT — femoral, popliteal, iliac
- Distal DVT — below knee, calf veins
- Two-point vs whole-leg protocol
- Doppler waveforms — phasicity, augmentation
- Chronic vs acute DVT — echogenicity, compressibility
- Upper extremity DVT — subclavian, axillary, brachial
- IVC thrombus — bilateral DVT, pelvic mass
Gynecologic and Obstetric Emergencies
Pelvic ultrasound is the primary tool for suspected ectopic pregnancy, ovarian torsion, and first-trimester complications. RadCall covers the beta-hCG discriminatory zone, transvaginal technique, and Doppler findings for torsion.
- Ectopic pregnancy — adnexal mass, free fluid, empty uterus
- Beta-hCG discriminatory zone — 1500–2000 mIU/mL (transvaginal)
- Interstitial ectopic — myometrial mantle measurement
- Ovarian torsion — enlarged ovary, peripheral follicles, Doppler
- Absent Doppler — not required for diagnosis of torsion
- Ovarian cyst — hemorrhagic, dermoid, endometrioma features
- Subchorionic hematoma — location, size, prognosis
- Heterotopic pregnancy — IVF patients, concurrent IUP and ectopic
Other Acute US Studies
- Appendicitis — non-compressible, >6 mm, periappendiceal fat
- Renal US — hydronephrosis grading, resistive index
- Testicular torsion — absent flow, enlarged epididymis
- FAST exam — Morrison's pouch, splenorenal, pericardial, pelvis
- Aortic aneurysm — diameter measurement, screening
- Intussusception — target sign, pseudokidney sign
- Pyloric stenosis — muscle thickness >3 mm, channel >17 mm
- Soft tissue infection — abscess vs cellulitis, cobblestoning