Inclusions: (click for further info)
Exclusions: (click for further info)
If you have any queries or need clinical advice as to the appropriateness of the request, please contact the chosen provider for information. The provider is at liberty to refuse a request or phone the clinician for further details if they feel the imaging is inappropriate.
When considering ordering imaging, please consider the following:
The brief information below is a guide and does not replace the full advice, diagnosis and management that an outpatient referral can give. Please refer to the RCR iRefer Guidelines for further information.
General Abdominal NOUS: (click for further info)
Please also see iRefer Guidelines.
Gynaecological NOUS: (click for further info)
USS pelvis for gynaecological conditions is indicated for:
Abdominal aortic aneurysm: (click for further info)
Jaundice: (click for further info)
Known cirrhosis: complications: (click for further info)
Palpable mass: (click for further info)
Pancreatitis: chronic: (click for further info)
Suspected gall bladder disease or post-cholycystectomy pain: (click for further info)
Lost intrauterine contraceptive device (IUCD): (click for further info)
Pelvic pain, including suspected pelvic inflammatory disease and suspected
endometriosis: (click for further info)
Postmenopausal bleeding: to exclude significant endometrial pathology:
(click for further info)
Suspected pelvic mass: (click for further info)
Suspected polycystic ovary syndrome: (click for further info)
Polycystic ovary syndrome is a clinical and biochemical diagnosis. At least 2 of these criteria are required:
The diagnosis os a polycystic ovary on US requires the demonstration of at least 12 follicles measuring 2-9mm in diameter and/or an ovarian volume in excess of 10ml.
Soft tissue mass: (click for further info)
US is useful as the first investigation to evaluate cystic and solid masses, and to distinguish them from pseudotumours. It is also useful to monitor benign masses (e.g. haematomas) and to assess for local recurrence of soft tissue sarcomas.
Local soft tissue ultrasound pathway to follow
Lower urinary tract symptoms: (click for further info)
Bladder US (with measurement of post-void residual volume and urine flow rate) is helpful in LUTS. Renal US to check for upper tract dilatation only if there is a post-void residue.
Renal insufficiency, haematuria, stone or infection: (click for further info)
US also indicated for renal insufficiency, haematuria, stones or infection.
Renal failure: (click for further info)
US is indicated as the first investigation in renal failure to measure kidney size and parenchymal thickness and to check for pelvicalyceal dilatation indicating possible obstruction. US may also be used to guide renal biopsy when histological diagnosis is required.
Suspected pre-renal failure requires US alone. Renal causes are best investigated with US, then possibly NM and US-guided biopsy. Post-renal/obstructive causes require CT/MRI, in addition to US.
Renal mass: (click for further info)
US is sensitive at detecting renal masses >2 cm and accurately distinguishes cystic or solid masses and helps to characterise some masses indeterminate at CT. Contrast-enhanced ultrasound can be useful for further characterisation of small solid or cystic renal masses.
Scrotal mass: (click for further info)
US with colour Doppler is indicated for testicular or scrotal swelling or when presumed inflammatory pain does not resolve. A painless testicular swelling requires urgent investigation. US allows differentiation of testicular from extra-testicular lesions.
Urinary tract obstruction: diagnosis and causes: (click for further info)
US can be used to assess the degree of collecting system dilatation (not always due to obstruction), the Doppler spectral pattern of intrarenal blood flow, the bladder, and the presence of ureteric jets.
Direct Access Ultrasound Referral Pathway: (click for further info)