Bladder filling defect: move it, then add colour

Question 1Echogenic material lies on the dependent wall of the bladder. What do you do first to tell clot from a wall lesion?

1. aReposition the patient and rescan to see if it moves
2. bSwitch to the linear probe
3. cMeasure its diameter
4. dPress firmly with the probe

Question 2Which colour Doppler finding favours a bladder wall lesion over clot?

1. aVessels inside the mass
2. bTwinkling artefact behind a bright focus
3. cNo flow inside the mass
4. dFlow in the bladder wall next to the mass

Question 3An elderly patient has visible haematuria and an avascular echogenic mass that does not move. What is the safest conclusion?

1. aIt is the catheter balloon
2. bIt is clot and needs no follow-up
3. cIt is a bladder stone
4. dIt is indeterminate and needs urology assessment