VideoOTW: Ureteral jets

Posted on: February 12, 2020, by :

This video demonstrates a ureteral jet.

Ureteral jets are the normal ejection of urine from the ureter into the bladder due to calyceal persistalsis. They are often seen during routine ultrasound of the bladder. You see a short burst of echoic material from about the 4o’clock position on the transverse image of a bladder (at the location of the vesicoureteral junction). The direction of a normal jet is anteromedial and upward as in this video.

In adults, the absence of jets or low-continuous jets in an otherwise well hydrated patient may indicate unilateral ureteral calculi (obstruction).1 Studies are being done to understand how different velocities of this jet may have clinical significance in children, including use in conjunction with voiding cystourethrogram (VCUG) to diagnose types of vesicoureteral reflux (VUR).2, 3 Doppler waveforms in obstructive uropathy have shown slower average jet velocity, shorter duration and decreased frequency. 4 Its use in the ED is probably limited to evaluation of acute ureteral obstruction from renal calculi.

1.Burge, H. J., Middleton, W. D., McClennan, B. L., & Hildebolt, C. F. (1991). Ureteral jets in healthy subjects and in patients with unilateral ureteral calculi: comparison with color Doppler US. Radiology, 180(2), 437-442.

2 Jequier, S., Paltiel, H., & Lafortune, M. (1990). Ureterovesical jets in infants and children: duplex and color Doppler US studies. Radiology, 175(2), 349-353.

3.Novljan, G., Levart, T. K., Ključevšek, D., Kenig, A., & Kenda, R. B. (2010). Ultrasound detection of vesicoureteral reflux in children. The Journal of urology, 184(1), 319-324.

4. Wu, C. C. (2010). Ureteric Jet. Journal of Medical Ultrasound, 18(4), 141-146.

Rosemary Thomas-Mohtat MD

Pediatric Emergency Medicine Attending at Children's National Health System
Rosemary has lived an adventurous life both geographically and professionally. She grew up an army brat in India living in 5 cities in her ten years there, then schooling in the many boroughs of NYC.Her professional journey has involved residency and a year of private practice in Pittsburgh, followed by a fellowship in Pediatric Nephrology at Montefiore and a year of bench genetics research at Columbia University, all the while working in a Peds ER in the Bronx. It was there that she found her true calling! She graduated PEM Fellowship at Children's National Medical Center, and then completed a one year Point of Care Ultrasound (POCUS) Fellowship. In her spare time, she loves running around Bethesda and the world with her family, including 2 sweet kiddos.
Rosemary Thomas-Mohtat MD

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