Vesical Calculus / Bladder Stone ultrasound

Diagnostic Sonography • Case Study Atlas

Vesical Calculus / Bladder Stone

A structured ultrasound case study covering clinical presentation, sonographic morphology, image interpretation, reporting and diagnostic learning points.

URINARY BLADDER ULTRASOUND CASE STUDY

Case Index

01 Vesical Calculus / Bladder Stone →

Chapter 01 • Case Study

Vesical Calculus / Bladder Stone

01 Clinical History

Patient presents with lower urinary tract symptoms such as dysuria, increased urinary frequency, suprapubic discomfort and/or intermittent difficulty in passing urine.

Ultrasound examination of the urinary bladder demonstrates a discrete echogenic calculus within the bladder lumen.

The lesion should be assessed for mobility, posterior acoustic shadowing, size, number and relationship to the bladder wall.

02 Ultrasound Image

Figure 1. Ultrasound image demonstrating an echogenic vesical calculus within the urinary bladder with posterior acoustic shadowing.

03 Ultrasound Morphology

Feature	Sonographic Description
Location	Echogenic calculus located within the urinary bladder lumen.
Appearance	Well-defined hyperechoic or echogenic focus demonstrating conspicuous echogenicity relative to urine.
Posterior Acoustic Shadow	Clean or variable posterior acoustic shadowing may be demonstrated behind the calculus.
Mobility	A freely mobile bladder calculus may change position with patient repositioning. Mobility should be assessed whenever technically possible.
Number	A single calculus or multiple vesical calculi may be identified.
Size	Maximum calculus diameter should be measured in two orthogonal planes whenever possible.
Bladder Wall	Assess the bladder wall for thickening, trabeculation, focal irregularity or associated inflammatory changes.
Bladder Distension	Assessment should consider the degree of bladder distension because inadequate filling can limit evaluation.
Associated Findings	Evaluate for hydronephrosis, upper urinary tract dilatation, urinary retention, prostatic enlargement in appropriate patients and other urinary tract abnormalities.

04 Ultrasound Report

An echogenic calculus is visualized within the urinary bladder lumen, demonstrating posterior acoustic shadowing.

The calculus measures approximately ______ mm in maximum dimension.

The bladder is assessed for wall thickening, trabeculation and other associated abnormalities.

The degree of bladder distension and post-void residual urine, when clinically indicated, should be documented.

The visualized upper urinary tracts should be assessed for associated hydronephrosis or other abnormalities.

05 Impression

Sonographic Impression Vesical calculus / urinary bladder stone identified within the urinary bladder lumen, with posterior acoustic shadowing.

Correlate with urinary symptoms and evaluate for associated urinary tract obstruction, bladder wall changes and underlying predisposing factors where clinically appropriate.

06 Recommendation

Correlate the sonographic finding with the patient's clinical symptoms and laboratory findings where appropriate.

Document the calculus size, number, location, mobility and degree of posterior acoustic shadowing.

Assess the urinary bladder wall and evaluate the upper urinary tract for associated obstruction or hydronephrosis.

Clinical/urological evaluation may be considered depending on calculus size, symptoms, urinary obstruction, recurrent stone disease and the underlying clinical context.

07 Learning Points

A vesical calculus typically appears as a discrete echogenic focus within the urinary bladder.

Posterior acoustic shadowing is an important sonographic feature supporting the presence of a urinary calculus.

Mobility can help distinguish a freely mobile bladder stone from a fixed calcified lesion associated with the bladder wall.

Calculus size and number should be documented because they are clinically relevant.

The bladder wall should be examined for associated thickening, trabeculation or other abnormalities.

Evaluation of the kidneys and ureters is important when associated urinary obstruction or upper urinary tract dilatation is suspected.

Adequate bladder filling improves visualization and characterization of intravesical calculi.

Sonographic findings should be interpreted together with clinical symptoms and other relevant investigations.

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