Right Upper Quadrant Pain: Ultrasound First!

J Ultrasound Med. 2017 Oct;36(10):1975-1985. doi: 10.1002/jum.14274. Epub 2017 Jun 6.

Abstract

Acute right upper quadrant (RUQ) pain is a common presenting symptom in emergency departments and outpatient medical practices, and is most commonly attributable to biliary and hepatic pathology. Ultrasound should be used as a first-line imaging modality for the diagnosis of gallstones and cholecystitis, as it allows the differentiation of medical and surgical causes of upper abdominal pathology, and in many circumstances is sufficient to guide patient management. Knowledge of strengths and limitations of ultrasound in the evaluation of RUQ is paramount in correct diagnosis. A spectrum of RUQ pathology for which a RUQ ultrasound examination should reasonably be considered as the initial imaging modality of choice will be reviewed.

Keywords: acute cholecystitis; biliary colic; choledocholithiasis; gallbladder; right upper quadrant pain; ultrasound.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdominal Pain / diagnostic imaging
  • Abdominal Pain / etiology*
  • Biliary Tract / diagnostic imaging
  • Biliary Tract Diseases / complications
  • Biliary Tract Diseases / diagnostic imaging*
  • Cholecystitis / complications
  • Cholecystitis / diagnostic imaging*
  • Cholelithiasis / complications
  • Cholelithiasis / diagnostic imaging
  • Diagnosis, Differential
  • Emergency Service, Hospital
  • Female
  • Gallbladder / diagnostic imaging
  • Humans
  • Liver / diagnostic imaging
  • Liver Diseases / complications
  • Liver Diseases / diagnostic imaging*
  • Middle Aged
  • Ultrasonography / methods*