INTRO TO RUQ
Clinically, right upper quadrant (RUQ) ultrasounds can be used...
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As a component of the FAST (Focused Assessment with Sonography in Trauma), to look for free fluid in the abdomen
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​To assess the hepatobiliary system, specifically for gallbladder and/or bile duct pathology when patients have RUQ pain
Now let's start with the anatomy.
In a RUQ ultrasound some of the relevant structures we may see include:
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Liver
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Gallbladder
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Right Kidney
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Thoracic/Lumbar Vertebrae
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Common Bile Duct
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Inferior Vena Cava
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Portal Vein
OpenStax, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons
How to get the RUQ Coronal view
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Place the probe in a coronal plane with the probe indicator pointing superiorly, toward the patient’s head
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Probe is placed in the mid-axillary line around the level of the 10th rib
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Probe can be translated superiorly and inferiorly to find the structures you want to identify
Note: The coronal view is the initial view used in the FAST exam​
How to get the RUQ Axial view
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Place the probe in an axial or transverse plane with the indicator toward the patient's right side
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Start with the probe just inferior to the right ribs, approximately in the mid-clavicular line
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The probe can be translated across the right anterior abdomen to visualize different structures
How to get the RUQ Sagittal view
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Place the probe in a sagittal (longitudinal) plane with the probe indicator pointing toward the patient’s head
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Start with the probe just inferior to the patient's right rib cage, approximately at the mid-clavicular line
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The probe can be translated across the right anterior abdomen to visualize different structures
Head
Mid-axillary line
Feet
Left
Right
Mid-clavicular line
Head
Feet
Mid-clavicular line
Head
Feet
= Probe Indicator
Probe Choice
For abdominal ultrasounds like RUQ, we typically use the curvilinear probe (as seen in images above). This probe has the lowest frequency, with the deepest penetration to visualize solid organs in the abdominal cavity. You can also consider using the phased array probe if you have a smaller patient, as it has a slightly higher frequency and penetrates less deeply, but has a smaller footprint to maneuver between rib spaces.
Now you are ready to see these views and anatomy in action.