Physical examination in acute kidney injury commences with kidney POCUS and concludes with a thorough evaluation of the hemodynamic circuit. It is important to note that kidney ultrasound should always include a bladder assessment. Below are images of the urinary bladder obtained from a patient with acute kidney injury. There was no hematuria or dysuria but the patient had a history of benign prostatic hyperplasia.

These images depict a relatively irregular growth emerging from the bladder wall, sharing similar tissue characteristics. This finding raises suspicion of a bladder neoplasm, prompting referral to urology for potential cystoscopy. Although a bladder clot is a possibility, color Doppler imaging reveals blood flow within the lesion, making a neoplasm more probable. Moreover, clots typically appear in individuals with traumatic Foley insertion or hematuria.