Right Upper Quadrant Ultrasound
Medical necessity: Evaluate for gallstones and dilated common bile duct and sonographic signs or cholecystitis, such as “positive sonographic Murphy’s sign,” thickened gall bladder wall, and pericholecystic fluid
Structures studied: Gallbladder (GB), common bile duct
1.) Obtain a video clip of the GB in it’s entirety, in both the longitudinal and transverse planes.
2.) Obtain a static image of the GB in the transverse plane with a measurement of the anterior GB wall.
3.) Obtain a static image of the Common bile duct (CBD).
COMMON BILE DUCT
- <5mm-normal in patients up to age 50 (Add 1 mm for every decade of life thereafter)
- 5-7mm equivocal
Note: The left lateral decubitis, in addition to the supine position, is generally superior for the GB and CBD visualization.