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Twinkling artifact, described by Rahmouni et al in 1996, appears as a rapidly alternating red and blue color Doppler signal behind certain stationary objects, such as stone. It has been reported mainly association with urinary calculi in only a handful of studies, showing the usefulness in equivocal case on sonography. For better visualization of distal ureter and ureterovesical junction(UVJ) on transabdominal sonography, full bladder technique by oral fluid ingestion has been usually performed at radiology department. However, it is time consuming work-up with some limitation, therefore not appropriate with many cases in busy urban ED. For rapid bladder distension on sonography, some authors suggested effective alternative approach, rapid intravenous hydration, rarely reported in related English literatures. I report a case with UVJ stone confirmed by twinkling artifact and alternative quick bladder filling with transabdominal ultrasonography.


Twinkling artifact, described by Rahmouni et al in 1996, appears as a rapidly alternating red and blue color Doppler signal behind certain stationary objects, such as stone. It has been reported mainly association with urinary calculi in only a handful of studies, showing the usefulness in equivocal case on sonography. For better visualization of distal ureter and ureterovesical junction(UVJ) on transabdominal sonography, full bladder technique by oral fluid ingestion has been usually performed at radiology department. However, it is time consuming work-up with some limitation, therefore not appropriate with many cases in busy urban ED. For rapid bladder distension on sonography, some authors suggested effective alternative approach, rapid intravenous hydration, rarely reported in related English literatures. I report a case with UVJ stone confirmed by twinkling artifact and alternative quick bladder filling with transabdominal ultrasonography.