Application of office ultrasound in the management of the spinal cord injury patient

Abstract

The effectiveness of office ultrasonography of the bladder and kidneys to provide routine urological followup was assessed in the outpatient spinal cord injury clinic. A total of 86 asymptomatic spinal cord injury patients underwent office ultrasonography of the kidneys and bladder as part of the routine urological followup. There were 106 ultrasound scans performed. Of the patients 68 had a blinded excretory urogram for comparison, including 20 who underwent additional studies (computerized tomography scans of the abdomen and pelvis, and/or radiologist-performed ultrasound examinations of the kidneys and bladder). All 18 patients who underwent office ultrasound but not excretory urography each underwent computerized tomography scans of the abdomen and pelvis and/or radiologist-performed ultrasound examinations of the kidneys and bladder. Office ultrasound detected 5 of 6 kidney stones, 6 of 6 hydronephrotic kidneys, 5 of 7 renal masses (4 of 6 cysts and 1 of 1 renal tumor), 3 of 3 bladder stones and 3 of 3 bladder diverticula. Subtle changes of chronic renal infection noted on excretory urography in 4 patients were not detected on corresponding ultrasound scans but voiding cystourethrograms revealed no reflux, and comparison to prior studies confirmed that these renal units were stable. Outpatient ultrasonography performed by the urologist proved to be a cost-effective and sensitive screening examination for urological disorders in the spinal cord injury population. The technique is easily learned, well tolerated and indicated when further urological evaluation is required.