49-year-old female with tender nodule in the right upper quadrant, evaluate consistency and rule out abscess, liver/gallbladder pathology. LIVER: Measures 20.3 cm in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: Increased renal echogenicity without hydronephrosis. Lobulated contour of the left kidney without discrete mass. Cyst in the left mid polar region measures 1.2 cm, without septation or solid component.OTHER: Sonographic examination of the patient's superficial palpable nodule in the right upper quadrant demonstrates a hypoechoic lesion which appears contiguous with rib both medially and laterally, and may represent a chronic rib fracture with associated callus formation. The patient was not tender to palpation and denies known history of trauma to that location, however a neoplasm cannot be entirely excluded sonographically.
1. Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. No evidence of cholecystitis, biliary obstruction, or abscess.2. Increased renal echogenicity consistent with medical renal disease without hydronephrosis. Lobulated contour of the left kidney without discrete mass.3. Hypoechoic superficial lesion in the area of the patient's palpable nodule appears contiguous with rib both medially and laterally, and may represent a chronic rib fracture with associated callus formation. However, a neoplasm cannot be entirely excluded sonographically. If further imaging evaluation is warranted, dedicated rib series radiographs or CT may be considered.