For those of you who might not know, I had a 9 month stint in radiology. I thought it might be the career for me - sessional speciality, diagnosis focussed and a great lifestyle. I quickly realised that it probably was not the career for me as I really missed patients but I certainly learnt lots from there.
What was most intriguing is how far medical imaging has come. Most of us are acquainted with x-ray interpretation but that’s as far as our image interpretation goes. Certainly after X-rays, ultrasound imaging is the most common type of imaging. I’ve probably requested hundreds of ultrasound for abdominal pain and at times, it’s helpful to know exactly what an ultrasound can uncover so as to appropriately request imaging. I thought I’d use this weeks newsletter to showcase some ultrasound images for conditions affecting the liver and gallbladder.
Principles of ultrasound
Ultrasound works by sending high-frequency sound waves into the body using a transducer. These waves bounce off tissues and organs, creating echoes that are captured and converted into real-time images by a computer. Sonographers can alter the angles and planes (transverse vs longitudinal) to visualise various organs.
Abdominal pain is a common reason for why we perform ultrasound. Visualising the gallbladder is part of this and a monographer will measures:
Gallbladder size and contents
Wall thickness (to assess inflammation —> cholecystitis)
Common Bile Duct (diameter < 7mm is normal)
Here are a series of images that illustrate common pathology:




Liver pathology on ultrasound
As well as telling us about gallbladder pathology, an ultrasound scan is also a useful way to assess the liver for both benign and serious pathology. This includes:
Fatty liver disease
Hepatocellular carcinoma
Liver Cirrhosis





That’s the end of our little series on liver and gallbladder ultrasound imaging. We hope that brings your ultrasound requests “to life” as we always feel that knowing what an onward referral can uncover is always helpful for a better clinical assessment and more accurate requests for investigations.
CPD Pain Management Masterclass
Finally, on the topic of pain, don’t forget to sign onto our CPD accredited Pain Management Masterclass on Sunday 2nd March 2025. It will be recorded so you will have the chance to watch again! You can read more here.
Until next time.
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