Ultrasound Protocol Library / Renal Ultrasound Protocol
Examination protocol
Renal Ultrasound Protocol
A systematic demonstration of bilateral renal ultrasound, from patient preparation and transducer orientation through multiplanar survey, measurements, image acquisition, and documentation.
Protocol demonstration
Renal Ultrasound Examination Protocol
Watch the complete examination once, then repeat it while following the preparation and documentation guide below.
Before the examination
Preparation
- Confirm the order, clinical indication, relevant history, and the structures that must be evaluated.
- Select an appropriate abdominal transducer and renal preset; verify patient identification and explain the examination.
- Begin supine and use decubitus, oblique, prone, or an intercostal approach as needed to obtain complete windows.
- Preserve privacy and follow local bladder-preparation and infection-prevention requirements.
During the examination
Scanning sequence
- Survey each kidney in longitudinal and transverse planes, including the upper pole, mid kidney, and lower pole.
- Evaluate the renal cortex, medulla, sinus, collecting system, and surrounding tissues while optimizing depth, focus, and gain.
- Measure renal length in a true long-axis image and obtain any additional measurements required by the indication or local protocol.
- Compare both kidneys and evaluate the urinary bladder, distal ureters, or Doppler findings when clinically indicated.
Required record
Images and documentation
- Representative labeled long-axis and transverse images of both kidneys, including upper and lower poles.
- Renal length and any other dimensions required by the practice protocol.
- Each abnormality in two orthogonal planes, with measurements and Doppler assessment when relevant.
- Relevant bladder images, volume, ureteral jets, or postvoid residual when included in the ordered examination.
Quality review
Common pitfalls
- Missing a renal pole because of rib shadowing, bowel gas, or an incomplete sweep.
- Using excessive gain or an oblique plane that obscures anatomy or distorts measurements.
- Mistaking normal variants, renal sinus fat, or adjacent structures for pathology.
- Stopping before alternate positions or windows are attempted when the initial examination is limited.
Knowledge check
Check your understanding
Answer each question before opening it to compare your response with the teaching point.
Why should renal length be measured in a true long-axis image?
An oblique or foreshortened image can underestimate length. The long axis should display the kidney from upper to lower pole before the calipers are placed.
What confirms that the renal survey is complete?
Both kidneys have been swept in longitudinal and transverse planes, the poles are included, representative images and required measurements are stored, and any abnormality is documented in two planes.
What should you do when ribs or bowel gas obscure part of a kidney?
Change the breathing instruction, patient position, or acoustic window and document any persistent limitation according to practice policy.