Last term Mikal had a young boy who had been kneed in the back during footy. He had R loin tenderness. Otherwise his abdominal examination and vital signs were normal. eFAST done at the time was also normal. However, given the area of tenderness and clinical suspicion, Mikal extended the FAST to visualise the R kidney. He found perinephric free fluid and free fluid around the inferior pole of the kidney (see below).
R kidney long axis. Superior pole obscured by rib shadowing. FF around inferior pole (see annotated diagram below).
CT revealed a inferior pole renal contusion. The patient was treated conservatively and had an uneventful recovery. However, the diagnosis was made and appropriate disposition could be organised prior to the CT.