Right upper quadrant pain. Clinician professes to feel a mass in the right upper quadrant. Obstructive LFTS. No prior ultrasound.
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Thin-walled gallbladder containing multiple small stones.
The CBD is dilated measuring 1.2cm. Mild intrahepatic duct dilatation.
6mm stone in the distal CBD just above the ampulla of Vater.
Small renal cortical cysts.
CBD stones can be observed on CT but it isn't the preferred modality.
In an ideal situation, ultrasound should be the first imaging investigation for painful jaundice to assess for gallstone disease.
MRCP may then be used if required prior to ERCP.
For painless jaundice ultrasound is also often indicated first with CT the most likely next investigation.
Vetting of imaging requests remains a noble, but unpopular, sport!