Kidney ultrasound—recognizing surrounding landmarks

Learn how to identify the kidneys and surrounding landmarks on an ultrasound image.

Nikolaus Mayr, MD
Nikolaus Mayr, MD
7th Nov 2017 • 3m read

Journey through the kidneys with an ultrasound probe in this fast-paced video by Dr Nikolaus Mayr. By the end of this video, you'll be be able to identify the left and right kidneys on an ultrasound display and know where they are in relation to other anatomical landmarks around them.

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Video Transcript

[00:00:00] There are two important structures to look for when trying to find the kidney. First of all, we will look to find the right kidney long section. For that, we will look for the Morison’s pouch. We should use a transcostal view on the right hypochondriac region, to see the right kidney in long section. The Morison's pouch is a thin echogenic line between the right liver lobe and the right kidney. In this view, we can also see the psoas muscle and the quadratus lumborum muscle, bordering

[00:00:30] the kidney dorsally. We can also see the hypoechoic renal sinus inside the kidney. Here it is on ultrasound. We see the thin echogenic line, between the dorsal border of the right liver lobe and the right kidney, forming the Morison's pouch. We see the echogenic renal sinus, here and the psoas and quadratus lumborum muscles. Take a second to look at this image. To find the left kidney long section, we will use a trancostal

[00:01:00] view over the left hypochondriac region. We can see the spleen and the vertebral column. Between the spleen and the left kidney, we will see the splenorenal recess. Just like in examining the right kidney, we can see the psoas muscle underneath the left kidney. This is what it looks like in ultrasound. We see the spleen, here, the left kidney, here, in long section. We see the psoas muscle. We see the vertebral column and, here, you see the echogenic line, the splenorenal recess.

[00:01:30] Take a moment to look at the image. Now, let's see if we can find these landmarks in live ultrasound. In this video, we see the long section of the right kidney. We see the right liver lobe, here. We see the Morison’s pouch, this echogenic line, right here. We see the renal medulla has hypoechoic region. We see the renal cortex. Now, we go on a cross-section and we can see

[00:02:00] the Morison’s pouch, right here and if we put on the Doppler, we even can distinguish the different vascular structures going into the kidney, with the vein being blue and the artery being red. In this video, we see the left kidney long section, right here. This is the psoas muscle underneath. We can see the spleen bordering the left kidney, right here and the splenorenal recess, this echogenic line, right here. And then we also see the hypoechoic

[00:02:30] regions that are the renal medulla and the renal sinus that is very echogenic. If we go into a cross-section, we can also see the echogenic structure, here, which is the renal sinus and we see the psoas muscle right underneath the kidney, right here. We also see the splenorenal recess again, right here.

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