KEY FACTS
Terminology
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Concretions of mineral salts/crystal within bladder lumen
Imaging
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Mobile avascular echogenic focus/foci in bladder with posterior acoustic shadowing on US
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May see associated twinkling artifact on color Doppler
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Smooth, round or ovoid lamellated calcification in bladder region on plain radiograph
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May see associated bladder wall thickening, internal echoes, or debris
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Calcific density in bladder, of varying size and shape, often lamellated on NECT or CECT
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Low signal intensity on all MR sequences
Top Differential Diagnoses
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Bladder neoplasm
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Blood clot
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Fungal ball
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Prostatomegaly
Pathology
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Stasis: Bladder outlet obstruction, neurogenic bladder, bladder diverticula
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Infection, especially proteus mirabilis
Clinical Issues
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Most asymptomatic
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May present with hematuria, suprapubic pain, or UTI
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Complication: Increased risk of developing malignant bladder tumors due to chronic irritation
Scanning Tips
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Carcinoma resulting from chronic bladder irritation may coexist with bladder stone
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Examine with color Doppler to exclude underlying vascularity, which can be seen with neoplasm
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Pulsed wave Doppler may help confirm real flow vs. twinkling artifact or motion
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Move focal point at or just below level of stone to best visualize posterior acoustic shadowing
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Roll patient or ask patient to cough to see if calcification is mobile
within the urinary bladder. The stone is lobulated in contour and associated with posterior acoustic shadowing 
. Note the diffuse bladder wall thickening 
related to chronic bladder outlet obstruction, a known risk factor for development of bladder calculi.Related posts:
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