In this radiology lecture, we review the ultrasound appearance of endometrial polyps!
Key teaching points include:
* Endometrial polyps are benign hyperplastic overgrowths of endometrial tissue.
* Sessile or pedunculated, can cause endometrial thickening.
* Often asymptomatic, may cause abnormal uterine bleeding or be associated with infertility.
* US appearance: Focal, echogenic, round or ovoid. Often best seen in proliferative phase of menstrual cycle (as opposed to secretory phase) due to increased contrast between echogenic polyp and hypoechoic functional layer of endometrium. May see hypoechoic halo inside margin of endometrium. Usually solid, but can have cystic changes.
* By comparison, submucosal fibroids are usually hypoechoic with posterior shadowing.
* A feeding vessel/vascular pedicle on color Doppler is 95% specific for endometrial polyp.
* Polyps can prolapse into cervix or vagina.
* Tx: Polypectomy if symptomatic.
To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://usa.samsunghealthcare.com/ultrasound/general-imaging/rs85-prestige (https://usa.samsunghealthcare.com/ultrasound/general-imaging/rs85-prestige)
Click the YouTube posts tab (https://www.youtube.com/@Radquarters/posts) or follow on social media for bonus teaching material posted throughout the week!
Instagram: https://www.instagram.com/Radquarters/ (https://www.instagram.com/Radquarters/)
Facebook: https://www.facebook.com/Radquarters/ (https://www.facebook.com/Radquarters/)
X (Twitter): https://twitter.com/Radquarters (https://twitter.com/Radquarters)
Reddit: https://www.reddit.com/user/radiologistHQ/ (https://www.reddit.com/user/radiologistHQ/)
Spotify: https://open.spotify.com/show/1fnqomovit3QxvS0uvPDBP?si=2142f24601014a63 (https://open.spotify.com/show/1fnqomovit3QxvS0uvPDBP?si=2142f24601014a63)
This video is for informational purposes only. It does not replace the advice or counsel of a doctor or health care professional.
30 Oct 2025
Ultrasound of Gout
In this radiology lecture, we review the ultrasound appearance of gout!
Key teaching points include:
* Gout is a crystal arthropathy due to monosodium urate crystal deposition in and around joints
* Most common in males over age 40
* Risk factors: Metabolic (hyperuricemia, obesity, diabetes, hypertension), renal (chronic kidney disease), dietary (high purine foods, sugary drinks, alcohol), and genetic (family history)
* Typically presents as acute monoarthritis with a red, inflamed, swollen joint. First metatarsophalangeal joint most common site of involvement (podagra)
* Can progress to asymmetric polyarticular disease and chronic tophaceous gout
* Ultrasound findings include: Joint effusion +/- hyperechoic foci (crystals/microtophi), synovial hypertrophy, and erosions typically at medial aspect of distal first metatarsal
* Erosions are juxtaarticular in distribution with overhanging edges yielding a “punched-out” appearance
* Gouty tophus: Amorphous, echogenic area containing internal hyperechoic foci surrounded by an anechoic inflammatory halo. May have associated cortical erosions
* Tophi may involve tendons, tendon sheaths, and bursae. Other common sites include olecranon region (elbow), patellar and popliteal tendons (knee)
* Double contour sign, AKA urate icing: Hyperechoic monosodium urate crystals coating hyaline cartilage surface. Disappears when serum urate levels drop below 6 mg/dL*
* Distinct from chondrocalcinosis seen in calcium pyrophosphate deposition disease which will have echogenic crystals within cartilage as opposed to on surface
References:
* *Thiele RG, Schlesinger N. Ultrasonography shows disappearance of monosodium urate crystal deposition on hyaline cartilage after sustained normouricemia is achieved. Rheumatol Int. 2010;30(4):495–503
* Jacobson JA. Fundamentals of Musculoskeletal Ultrasound. 3rd ed. Elsevier; 2018
To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4 (https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4)
Click the YouTube posts tab (https://www.youtube.com/@Radquarters/posts) or follow on social media for bonus teaching material posted throughout the week!
Instagram: https://www.instagram.com/Radquarters/ (https://www.instagram.com/Radquarters/)
Facebook: https://www.facebook.com/Radquarters/ (https://www.facebook.com/Radquarters/)
X (Twitter): https://twitter.com/Radquarters (https://twitter.com/Radquarters)
Reddit: https://www.reddit.com/user/radiologistHQ/ (https://www.reddit.com/user/radiologistHQ/)
Spotify: https://open.spotify.com/show/1fnqomovit3QxvS0uvPDBP?si=2142f24601014a63 (https://open.spotify.com/show/1fnqomovit3QxvS0uvPDBP?si=2142f24601014a63)
This video is for informational purposes only. It does not replace the advice or counsel of a doctor or health care professional.
14 Aug 2025
Ultrasound of Choledocholithiasis (Common Bile Duct Stones)
In this radiology lecture, we review the ultrasound appearance of choledocholithiasis (common bile duct stones)!
Key teaching points include:
* Choledocholithiasis = Stones within common bile duct (CBD)
* Seen in up to 15% of patients with cholelithiasis
* Clinical presentation: Asymptomatic, biliary colic, cholangitis, pancreatitis, jaundice
* On ultrasound, see rounded stone or stones in CBD
* Shadowing of stone less common than with cholelithiasis, twinkling artifact may help
* CBD dilatation defined as greater than 6 mm allowing for an additional 1 mm per decade above 60, or greater than 10 mm post-cholecystectomy.
* Intrahepatic dilatation and cholelithiasis may be present
* Sensitivity of US up to 40% for detecting CBD stones, but US accuracy 90% for detecting CBD dilatation
* If US negative and high clinical suspicious for choledocholithiasis, MRCP can be considered
* CT has reduced sensitivity with only 15-20% gallstones visible on CT
* Supportive lab values: Elevated serum bilirubin, alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT). AST and ALT may also be elevated, but less specific. Labs can even be normal in the setting of choledocholithiasis
* Tx may include endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy. Intraoperative cholangiogram during cholecystectomy
To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4 (https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4)
Click the YouTube posts tab (https://www.youtube.com/@Radquarters/posts) or follow on social media for bonus teaching material posted throughout the week!
Instagram: https://www.instagram.com/Radquarters/ (https://www.instagram.com/Radquarters/)
Facebook: https://www.facebook.com/Radquarters/ (https://www.facebook.com/Radquarters/)
X (Twitter): https://twitter.com/Radquarters (https://twitter.com/Radquarters)
Reddit: https://www.reddit.com/user/radiologistHQ/ (https://www.reddit.com/user/radiologistHQ/)
Spotify: https://open.spotify.com/show/1fnqomovit3QxvS0uvPDBP?si=918edad8f340434a (https://open.spotify.com/show/1fnqomovit3QxvS0uvPDBP?si=918edad8f340434a)
This video is for informational purposes only. It does not replace the advice or counsel of a doctor or health care professional.
Inside a recent episode
Ultrasound of Endometrial Polyps
Published 5 Mar 2026 · Transcript excerpt
[…] They're often asymptomatic, but they may cause abnormal uterine bleeding, or they can be associated with infertility. On ultrasound, these tend to be focal echogenic, meaning bright, round, or ovoid structures. And we usually see them best in the proliferative phase of the menstrual cycle as opposed to the later secretory phase. And that's because in the proliferative phase, we see this increased contrast between the echogenic polyp and the background hypoechoic or dark functional layer of the endometrium. In the secretory phase, the endometrium becomes diffusely echogenic due to edema and hormonal changes. […]
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