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Right Intercostal Oblique Ultrasound View
Aka: Right Intercostal Oblique Ultrasound View, Right Coronal Ultrasound View
- See Also
- FAST Exam
- Subcostal Echocardiogram View (Subxiphoid Echocardiogram View)
- Right Intercostal Oblique Ultrasound View
- Right Coronal Ultrasound View
- Left Intercostal Oblique Ultrasound View
- Left Coronal Ultrasound View
- Suprapubic Ultrasound View (Long Axis or Longitudinal View)
- Lung Ultrasound for Pneumothorax (Sliding Lung Sign, Lung Point)
- Emergency Echocardiography
- Ultrasound
- Indications
- FAST Exam
- Approach: Right Intercostal Oblique View (Right lower chest to RUQ)
- Transducer positioning
- Placement: Right lateral lower chest and upper Abdomen
- Axis: Long Access with indicator at 12:00
- May rotate indicator to oblique 10-11:00 to reduce rib shadowing
- Direction: Energy perpendicular to lateral chest towards Spleen
- Landmarks
- Diaphragm
- Liver
- Right Kidney may be visible in this view
- Conditions
- Right Hemothorax
- Posterior lateral wall bright attenuation artifact extends above diaphragm
- Black anechoic fluid (may have internal echoes if clotted blood)
- Lung tissue may be seen within black fluid, free floating
- Images



- Approach: Right Coronal View (RUQ to RLQ, pericolic and inferior renal pole)
- Obtain view by tilting transducer inferiorly from right intercostal view (or dropping down 1-2 rib spaces)
- Transducer positioning
- Placement: Right lateral Abdomen
- Axis: Long axis with indicator at 12:00
- Direction: Energy perpendicular to lateral Abdomen
- Pan transducer inferiorly to scan the inferior pole of Kidney
- Tilt transducer, sweeping from anterior to posterior Kidney
- Landmarks
- Liver
- Right Kidney
- Right Psoas Muscle
- Conditions
- Blood in Morrison's Pouch (between right Kidney and liver)
- Fat may appear similar to blood
- However fat has a homogeneous speckled appearance without change in size
- Blood Clot in Morrison's Pouch is a sign of catastrophic Hemorrhage (>1 Liter of blood in Abdomen)
- Fluid in Morrison's Pouch in the absence of Trauma
- Ascites may also appear as fluid in pouch, but will be diffuse
- In association with Acute Abdomen, suggests intraabdominal catastrophe
- Blood in Paracolic Gutter (anterior or superficial to right Kidney)
- In supine patients, paracolic gutter is lowest point in peritoneal cavity above pelvic brim
- Small blood accumulations may appear here first (prior to Morrison's pouch)
- Blood in Right Retroperitoneum
- Blood accumulates between Kidney and psoas Muscle
- Most blood in Retroperitoneum will be indistinguishable from Muscle
- Images


- Resources
- FAST Exam RUQ (Dr. Mandavia, Sonosite)
- http://www.youtube.com/watch?v=0VTRm_DNW8s
- FAST Exam RUQ -Normal (Dr. Mandavia, Sonosite)
- http://www.youtube.com/watch?v=lzgxZsFZhTU
- FAST Exam RUQ - Hemorrhage (Dr. Mandavia, SonoSite)
- http://www.youtube.com/watch?v=Gj5IioG7SyM
- References
- Reardon (2016) FAST Scan, Online Video Stabroom.com, accessed 4/1/2016
- Reardon (2013) Emergency Ultrasound Course, 3rd Rock Ultrasound, Minneapolis, MN
- Alameda County Trauma Service FAST Exam
- http://eastbay.surgery.ucsf.edu/eastbaytrauma/Protocols/ER%20protocol%20pages/FAST-files/FAST.htm
- Mateer (2012) Introduction to Trauma Ultrasound Video, GulfCoast Ultrasound, VL-95-T
- https://www.gcus.com/products/about.asp?product=338/Introduction-to-Trauma-Ultrasound
- HCMC FAST Exam
- http://vimeo.com/1044031