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Gallstones : Radiology

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Plain abdominal films can detect only 10-25% of gallstones. About 80% of cholesterol stones (the commonest type found in the Western countries) are radiolucent because they lack calcium carbonate. Among pigment stones, 50%-75% of black pigment stones are radiopaque due to calcium carbonate and calcium phosphate content. Most of the brown pigment stones are radiolucent.

These plain radiographs of the spine (frontal view - left; lateral view - right) are from a 75 y/o female who presented with back pain after sustaining a fall. The radiographs show compression fracture of L1 causing angular deformity of the vertebral endplate (horizontal arrow). Calcified gallstones (vertical arrow) were an incidental finding in the right upper quadrant.

Case courtesy of Sajoscha A. Sorrentino, Radiopaedia.org. From the case rID: 20123; used under Creative Commons License

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