NR Medical Academy

14/12/2025

30M, c/o poor urinary stream. This is image of his full bladder. Wall thickness is between 5-7mm.
Diagnosis is acute cystitis
KLINIK PAKAR X-RAY NR

14/12/2025

64M, recently discharged after admitted for 2/12 with pneumonia. Bed-ridden with underlying DM, on in-dwelling catheter. Pre-void images showing bladder volume of 354cc, thickened wall with sediments. This is chronic cystitis.
KLINIK PAKAR X-RAY NR

14/12/2025

50F, p/w acute onset abdominal pain.
Ultrasound showing 1.8cm gallstone impacted at the neck of gallbladder. GB wall is thickened and pericholecystic fluid present indicating GB inflammation.
Diagnosis is impacted 1.8cm gallstone with acute cholecystitis

Ultrasound signs of acute cholecystitis are
- Presence of gallstones
- Thickened gallbladder wall (>3mm)
- Pericholecystic fluid (fluid around the gallbladder)
- Gallbladder distension
- Positive sonographic Murphy's sign (similar to clinical Murphy's sign - tenderness when the probe presses the gallbladder)

KLINIK BAHARUDIN SHAH ALAM

14/12/2025

43F, p/w tender mobile lump
Ultrasound showing 2.42cm larg, non-vascular, hypoechoic mass with fairly well-defined margin. This is Cystosarcoma phyllodes aka Phyllodes tumour aka giant fibroadenoma.
Phyllodes tumor is a rare benign tumour of the breast with malignant potential. Peak age 45 (she is 43), usually unilateral and 10% are malignant.
Management is surgical excision.
KLINIK PAKAR WANITA DAN BERSALIN SUBANG PERMAI

14/12/2025

35F, recently diagnosed CKD stage 3. Latest creat 112, uric acid 615, EGFR 57. U/l diabetes mellitus.

Right kidney normal in size and echogenicity, bipolar length 12.98 cm.
Left kidney small in size and increased echogenicity, bipolar length 7.40 cm
Diagnosis: left renal atrophy

Causes of renal atrophy are:
Renal artery stenosis
Chronic pyelonephritis
Reflux nephropathy
Diabetic nephropathy

The kidney can also be congenitally small (hypoplasia or dysplasia)
KLINIK MYFAMILY SKUDAI

14/12/2025

23F, asymptomatic.
Ultrasound showing multiple small breast cysts in her left breast.
This is fibrocystic breast change.

What is fibrocystic breast change?
This is a physiological process – not pathological. You may have multiple small fibroadenomas or multiple breast cysts or combination of both. It can be unilateral or bilateral.
Fibrocystic breast change is a very common entity. Unusual before adolescence.
Most often diagnosed between the ages of 20 to 40 with the peak before or at menopause. Around the age of 35, degenerative structural changes begin to develop in the glandular tissue of the breast. Involution, with replacement of parenchyma by fat, is accompanied variably by fibrous tissue proliferation, micro- and macrocyst formation, and adenosis.

Clinically, may presents with breast pain that worsens during ovulation. On palpation, the breast feels lumpy. May fluctuates with menstrual cycle.
Treatment is just assurance.
KLINIK SOFEA BATU PAHAT

14/12/2025

56M, PMH thyrotoxicosis. P/w LOA,LOW ~18kg in 6/12. O/e no thyroid swelling, no nodules felt. Currently 5/12 on carbimazole 10mg od. TFT reduced TSH. Hyperthyroidism for assessment.

Both thyroid glands are normal in size but shows heterogenous echotexture and increased vascularity.
Two well-defined, avascular, solid heterogenous hyperechoic lesion noted pole and lower pole left thyroid lobe. They measure 1.7cm and 2.0cm respectively.

Combo images: top row right lobe showing coarse echotexture and generalised vascularity, consistent with thyrotoxicosis.
Bottom row: One of the non-functioning nodules.

Why do we do ultrasound in hyperthyroidism?
There are 2 causes of hyperthyroidism that we can see on ultrasound.
1. Grave disease
2. Functioning adenoma

In Grave disease, the glands shows coarse heterogenous echotexture with generalised increase in vascularity. In functioning adenoma, a hypervascular nodule is seen. The rest of thyroid is normal.
In Grave disease, preferred treatment is by medication but in functioning adenoma, treatment is surgical or radio-iodine therapy.
KMI TAWAU MEDICAL CENTRE

14/12/2025

36M, p/w right lumbar pain, severe, pain score 10/10. TRO renal/ureteric stone.
Combo images showing moderate right hydronephrosis and hydroureter with 5mm stone at upper ureter.
Next step is to do CTU – CT urography.
This will help us decide if the stone can pass out by itself or will need urological intervention.
KMI TAWAU MEDICAL

14/12/2025

WhatsApp Channel: a new way to upgrade your x-ray & ultrasound knowledge!

How to use my channel?
- Join as a follower
- Log in frequently (make it routine – check out every morning before you start work!)
- Use the search button to search for specific case (you can only see the last 30 days postings)
- React to the post by leaving behind an emoticon (happy, sad, surprise etc)
- Share a post with a friend and discuss the case
https://whatsapp.com/channel/0029VbBo6OYKgsNxHXzyt71H

Channel • 656 followers • Interesting x-ray & ultrasound cases from my clinic or reporting pool. Cases are being updated almost daily. All cases are original and come from various GP clinics on my panel. There is so much to learn. Got queries? Email me at radiology4gps@gmail.com. Dr Rahman

01/12/2025

Unlock your skills with the NR Mindray PoCUS Workshop Series!
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Choose Your Module of Interest:
Module A: HBS & KUB – 3 & 23 Dec 2025
Module B: Antenatal & Female Pelvis – 4 & 24 Dec 2025

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📞 Contact Pn. Azie at 012-970-1547
Don't miss this opportunity to elevate your practice—spots are limited, so act fast!

01/12/2025

CME 29 November 2025 ✨
100+ participants. We appreciate your participation ✨