Sample Report Alpha Dog

To DR.
Name Shamim Age 35 Years Date 06-11-2018

DR # 317 OPD/Indoor # 3052
Examination USG ABDOMEN
REPORT:-
 Liver (span 167mm_Normal Range up to- 160mm ) was enlarged & showed bright
echo texture with smooth surface. No focal lesion or dilated ducts seen. GB was
contracted. CBD (05mm) & PV (14mm) showed normal calibers. Pancreas showed
normal reflectivity & contours. Spleen (129mm_ Normal Range up to- 120mm) was
enlarged.
Kidneys showed normal echoe pattern. No calculus/hydronephrosis seen on either
side. UB was partially filled.
 No pleural effusion/Ascites.
IMPRESSION:
Hepatosplenomegaly
SUGGESTION:
Lab./Clinical Correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P
Ultrasound Specialist
Rtd-Medical Superintendent
DHQ Hospital Pakpattan

To DR.
Name Taj BB Age 35 Years Date 06-11-2018
REPORT:-
 Liver (span 141mm_Normal Range up to- 160mm) showed homogeneous echo

texture with smooth surface. No focal lesion or dilated ducts seen. GB was normal.
CBD (03mm) & PV (11mm) showed normal calibers. Visualized Pancreas showed
normal reflectivity & contours. Spleen (87mm_Normal Range up to- 120mm) was normal.
 Kidneys showed normal echoe pattern with good CMD. No calculus or
hydronephrosis seen on either side. UB was empty.
IMPRESSION:
Sonographically Unremarkable Study
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Perveen Akhtar Age 35 Years Date 06-11-2018
Examination USG ABDOMEN & PELVIS
REPORT:-
Liver (span 148mm_Normal Range up to- 160mm) showed homogeneous echo texture with
smooth surface. No focal lesion or dilated ducts seen. GB was normal. CBD (03mm) & PV
(11mm) showed normal calibers. Visualized Pancreas showed normal reflectivity & contours.
Spleen (87mm_Normal Range up to- 120mm) was normal.
Kidneys showed normal echoe pattern with good CMD. No calculus or hydronephrosis seen
on either side. UB was normal. Anteverted uterus measured 82x43x54mm and showed
central echo endometrial canal with thickness 07mm. No evidence of intrauterine mass was
seen. No adnexal mass seen. No free fluid was seen in the pelvis.
No pleural effusion.
IMPRESSION:
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Perveen Akhtar Age 05 Years Date 06-11-2018
REPORT:-
 Liver showed homogeneous echo texture with smooth surface. No focal lesion
or dilated ducts seen. GB was normal. CBD & PV showed normal calibers. Visualized
Pancreas showed normal reflectivity & contours. Spleen was normal.
hydronephrosis seen on either side. UB was normal.
IMPRESSION:
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Rani BB Age 55 Years Date 06-11-2018
REPORT:-
echo texture with smooth surface reflecting fatty change. No focal lesion or dilated
ducts seen. GB was normal. CBD (04mm) & PV (12mm) showed normal calibers.
Pancreas showed normal reflectivity & contours. Spleen (112mm_ Normal Range up to-
120mm) was normal.

 Kidneys showed normal echoe pattern with good CMD. No
calculus/hydronephrosis seen on either side. UB was partially filled.
 No pleural effusion /Ascites.
IMPRESSION:
Hepatomegaly
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Shamim Age 35 Years Date 06-11-2018
REPORT:-
echo texture with smooth surface. No focal lesion or dilated ducts seen. GB was
contracted. CBD (05mm) & PV (14mm) showed normal calibers. Pancreas showed
normal reflectivity & contours. Spleen (129mm_ Normal Range up to- 120mm) was
enlarged.
Kidneys showed normal echoe pattern. No calculus/hydronephrosis seen on either
side. UB was partially filled.
IMPRESSION:
Hepatosplenomegaly
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
REPORT:-
smooth surface. No focal lesion or dilated ducts seen. GB showed multiple calculi
intraluminally. Wall thickening measured 03mm at the average. No pericholecystic fluid was
seen. CBD (04mm) & PV (11mm) showed normal calibers. Pancreas showed normal
reflectivity & contours. Spleen (97mm_Normal Range up to- 120mm) was normal. Kidneys
showed normal echoe pattern. No calculus or hydronephrosis seen on either side. UB was
partially filled. No pleural effusion/ascites.
IMPRESSION:
Cholelithiasis
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
REPORT:-
Liver (Span 147mm_Normal Range up to -160mm ) showed coarse echo texture with irregular
surface reflecting diffuse parenchymal disease. No focal lesion or dilated ducts were seen.
GB was contracted. CBD (05mm_ Normal Range up to- 06mm ) showed normal calibre. PV
(16mm_Normal Range up to- 14mm ) was dilated. Pancreas showed normal reflectivity &
contours. Spleen (141mm_ Normal Range up to- 120mm ) was enlarged. Kidneys showed normal
echo pattern. No calculus or hydronephrosis seen on either side. UB was empty. No pleural
effusion/ascites.
IMPRESSION:
CLD
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
REPORT:-
FINDINGS:-
Liver (Span 156mm_Normal Range up to -160mm ) showed heterogeneous echoes with few
heterogeneous masses in diffuse fashion. No dilated ducts were seen. GB was acalculus with
diffusely edematous wall. CBD (05mm_ Normal Range up to- 06mm) showed normal calibre. PV
(16mm_Normal Range up to- 14mm ) was dilated. Pancreas showed normal reflectivity &
contours. Spleen (141mm_ Normal Range up to- 120mm ) was enlarged. Kidneys showed normal
echo pattern. No calculus or hydronephrosis seen on either side. UB was empty. No pleural
effusion. Ascites (++++) was seen.
IMPRESSION:
CLD accompanying mitotic change
SUGGESTION:
CECT/Lab./Clinical Correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To Dr.
Name M. Ali Age 70 Years Date 06-11-2018
Examinatio
USG ABDOMEN
n
REPORT: -
 Hepatobiliary system, pancreas & spleen were unremarkable.
 Kidneys showed increased sinus and echo pattern with loss of

corticomedullary differentiation. No evidence of calculus or hydronephrosis seen. UB
was partially filled.
 No pleural effusion/ascites was seen.
IMPRESSION:
Renal Parenchymal Insult
SUGGESTION:
Lab./Clinical correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To Dr.
REPORT:-
Hepatobiliary system, Pancreas, Spleen & Kidneys were unremarkable. UB was partially
filled. Tenderness was appreciated in RIF with diffusely edematous appendix, however no
mass / collection seen. No pleural effusion / ascites.
IMPRESSION:
Acute Appendicitis
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To Dr.
REPORT:-
Hepatobilliary system, Pancreas, Spleen & Kidneys were unremarkable. UB was partially
filled. Generalized tenderness was appreciated accompanying multiple grossly dilated,
fluid/food debris containing small gut loops in central abdomen. No pleural effusion /
ascites.
IMPRESSION:
Intestinal Obstruction
SUGGESTION:
XR/Lab./Clinical Correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To Dr.
Name Imran Age 23 Years Date 31-10-2018
Examination USG KUB
REPORT:-
 Kidneys showed normal echo pattern with good corticomedullary
differentiation bilaterally. No evidence of calculus / hydronephrosis seen. UB was
partially filled. No Ascites.
IMPRESSION:
SUGGESTIONS:
Clinical Correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To Dr.
Examinatio
USG KUB
n
REPORT:-
 Rt. Kidney (102x44x16mm) showed mild HN. Lt. Kidney (96x38x18mm)

showed normal echo pattern. No evidence of calculus or hydronephrosis seen. UB
was partially filled.
IMPRESSION:
Rt. Obstructive Uropathy
SUGGESTION:
Lab./Clinical Correlation/IVU
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
REPORT:-
smooth surface. No focal lesion or dilated ducts seen. GB was normal. CBD (03mm) & PV
(11mm) showed normal calibers. Visualized Pancreas showed normal reflectivity & contours.
Spleen (87mm_Normal Range up to- 120mm) was normal. Rt. Kidney showed normal sinus and
echo pattern with good corticomedullary differentiation. No evidence of calculus /
hydronephrosis seen. Lt. Kidney showed mild HN with evident few tiny calculi in the PCS.
UB was empty. No pleural effusion/Ascites.
IMPRESSION:
Lt. Obstructive Uropathy
SUGGESTION:
Lab./Clinical Correlation/IVU
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examination USG KUB
REPORT:-
Kidneys showed normal echoe pattern. No calculus or hydronephrosis seen on either side.
UB was normal (Approx. Urine Vol._157ml). No intra luminal calculus/wall thickening seen.
Prostate (Approx. Vol._49 ml) was enlarged. PMRV measured about 54ml. No pleural
effusion/Ascites.
IMPRESSION:
BPH
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examination USG Pelvis
REPORT:-
Anteverted uterus measured 82x43x54mm and showed central echo endometrial canal with
thickness 07mm. No evidence of intrauterine mass was seen. No adnexal mass seen. No
free fluid was seen in the pelvis.
IMPRESSION:
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
USG Pelvis
n
REPORT:-
Anteverted uterus measured 82x43x54mm and showed centre echo endometrial canal with
thickness 07mm. No evidence of intrauterine mass was seen. Rt. Adnexa showed 45x51mm
complex echoe mass abutting the Rt. Uterine border. No free fluid was seen in the pelvis.
IMPRESSION:
Complex Adnexal Mass
SUGGESTION:
Lab./CECT/Clinical Correlation
Complex adnexal mass may fall in one of the following entities:
Chocolate/Hemorrhagic Cyst
Ectopic Pregnancy
Ovarian Tumor
Hydro Salpinx
Organized Collection (Abscess/Hematoma)
Dermoid
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

DR. Jamil U Rehman
NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
USG OBS
n
Single intrauterine fetus having good cardiac activity & body movements was noted.
CRL 59mm
GA 12 Wks 02 Days (Approx.)
No uterine/adnexal mass seen.
IMPRESSION:
Single Alive Fetus
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examination USG OBS
REPORT:-
Single intrauterine fetus having good cardiac activity was noted. Liquor was adequate.
Placenta was posterior & high. Longitudinal Lie (Breech).
Growth Parameters:
BPD_90mm, FL_70mm, AC_301mm, EFW_ 2766 Grams
GA_36+ Weeks
IMPRESSION:
Unremarkable Study
SUGGESTIONS:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examination USG OBS
REPORT:-
Growth Parameters:
BPD_90mm, HC_312mm, FL_70mm, AC_301mm, EFW_ 2766 Grams
GA_36+ Weeks
Normal 3-vessel umbilical cord, normal cardiac 4 chamber view. Neural axis including spines
was normal. Transverse cerebellar diameter was 23mm. Abdominal wall was intact.
Stomach showed normal situs. Gut showed non echogenic (normal) appearance. Kidneys
and urinary bladder were normally visualized. No skeletal dysplasia. Cervical canal
measured 52mm and was competent.
UMBILICAL ARTERY Doppler showed: PI_0.99, RI_0.60, S/D_2.52. No evidence of
fetoplacental insufficiency.
IMPRESSION:
Unremarkable Study
SUGGESTIONS:
Clinical Correlation/Follow Up
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examination USG OBS
REPORT:-
Growth Parameters:
GA_36+ Weeks
was normal. Transverse cerebellar diameter was 23mm. Abdominal wall was intact.
Stomach showed normal situs. Gut showed non echogenic (normal) appearance. Kidneys
and urinary bladder were normally visualized. No skeletal dysplasia. Cervical canal
measured 52mm and was competent.
UMBILICAL ARTERY Doppler showed: PI_0.99, RI_0.60, S/D_2.52. No evidence of
BIOPHYSICAL PROFILE (BPP)
Cardiac Activity_02, Breathing Movements_02, Amniotic Fluid_02, Muscular Tone_02, Gross
Body Movements_02
Total_ 10/10
IMPRESSION:
Unremarkable Study
SUGGESTIONS:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examination USG OBS
REPORT:-
Placenta was posterior & high. Longitudinal Lie (Breech). Normal 3-vessel umbilical cord was
seen encircling neck in single loop fashion.
Growth Parameters:
GA_36+ Weeks
IMPRESSION:
CAN
SUGGESTIONS:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Sumaira Age 22 Years Date 13-09-2018
Examination USG OBS
REPORT:-
Mono Chorionic Tri Amniotic Alive Triplet Pregnancy was noted. Good cardiac activity was
seen in all the three foetuses. Liquor was adequate in all sacs. Placenta was fundo posterior
& right lateral. Internal os was competent & measured 52mm.
Fetus A Fetus B Fetus C
Presentatio Presentation Transverse &

Cephalic Presentation Cephalic
n Left lateral
BPD 56mm BPD 59mm BPD 61mm
FL 40mm FL 41mm FL 43mm
AC 171mm AC 177mm AC 192mm
GA 23 +Wks GA 23 +Wks GA 24 +Wks
All the Fetuses showed:
Normal 3-vessels cords, Neural Axis/Spines, GITs & GUTs. No obvious congenital anomaly
seen.
IMPRESSION:
Triplet Alive Pregnancy in good growth pattern
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examination USG OBS
REPORT:-
Di Chorionic Di Amniotic twin pregnancy was noted. Good cardiac activity seen in both.
Liqour was adequate in both sacs. Internal os was competent & measured 58mm.
Fetus A Fetus B
Placenta was Fundoposterior Placenta was Lt. Lateral with Calcific Change
Presentation Breech Presentation Breech
BPD 89mm BPD 93mm
FL 71mm FL 71mm
AC 306mm AC 311mm
GA 36 +Wks GA 36 +Wks
Both Fetuses showed:
Normal 3-vessels cords, Neural Axis/Spines, GITs & GUTs. No obvious congenital anomaly
seen.
IMPRESSION:
Twin Alive Pregnancy
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
USG OBS
n
Single intrauterine relatively irregularly contoured GS containing single embryo without

cardiac activity was noticed. Minimal fluid streak neighbouring the GS supported the
evidence of sub chorionic bleed.
CRL measured about 12mm; corresponding GA was 07+ Weeks. No uterine/adnexal mass
seen.
IMPRESSION:
Missed Abortion
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name BO Nadia Age 02 Days Date 27-10-2018
Examinatio
USG BRAIN
n
REPORT:-
Brain parenchyma showed normal appearances. No focal lesion/mid line shift appreciated.
Ventricular system appeared normal. Doppler indices appeared normal.
IMPRESSION:
Unremarkable Scan
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Nadia BB Age 25 Years Date 27-10-2018
Examinatio
USG NECK
n
FINDINGS:-
 Thyroid gland showed normal appearances. No focal lesion appreciated.
 Neck Vessels showed normal blood flow pattern. Muscular plans showed
normal echoes. No enlarged lymph node appreciated.
IMPRESSION:
Unremarkable Scan
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Naseem BB Age 35 Years Date 06-11-2018
Examinatio
USG Thyroid
n
FINDINGS:-
Thyroid gland was grossly enlarged secondary to multiple heterogeneous rounded masses of
varying sizes in diffuse fashion. Mild element of cystic component was also noticed. No
calcific focus was seen. Rich color filling noticed on CFI.
IMPRESSION:
MNG
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
USG Thyroid
n
FINDINGS:-
Both the lobes & Isthmus of thyroid gland were normal in size & showed normal
parenchymal echoes. No focal lesion appreciated.
IMPRESSION:
Unremarkable Scan
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
CAROTID DOPPLER (4_VESSEL STUDY)
n
FINDINGS:-
 Bilateral CCA and ICA showed normal spectral waveform and Doppler
parameters. No plaque of hemodynamic significance was seen on either side. Intima
media showed normal thickness bilaterally.
 Both ECA & Vertebral arteries showed forward flow pattern and normal
Doppler indices.
IMPRESSION:
Unremarkable Scan
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name M. Chiragh Age 75 Years Date 17-10-2018
Examinatio
CAROTID DOPPLER (4_VESSEL STUDY)
n
FINDINGS:-
 Rt. CCA showed a large (17.8x2.7mm) atheromatous plaque with few calcific
foci at the bifurcation extending into ICA causing almost 36% Diameter narrowing.
 Rt. CCA showed a large (23.2mmx3.1mm) atheromatous plaque with few

calcific foci at the bifurcation extending into ICA causing almost 41% Diameter
narrowing.
 Both ECA & Vertebral arteries showed normal flow pattern and doppler indices
too.
 Intimal thickness was also observed bilaterally.
Carotid Artery Stenosis Levels:

 No Stenosis
 <50% Stenosis
 50%-70% Stenosis
 >70% Stenosis
 Near Occlusion
 Total Occlusion
IMPRESSION:
Bilateral CCA Atheromatous Plaques
DR. Jamil U Rehman
NOT VALID FOR COURT
M.B.B.S, R.M.P

SUGGESTION:
Lab./Clinical correlation/Follow Up
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
DOPPLER UPPER EXTRIMITY
n
FINDINGS:-
VENOUS DOPPLER
Subclavian, axillary & brachial veins were evaluated with gray scale and doppler. Grey scale
sonography shows normal vein wall compression. CFI shows spontaneity, phasicity and
augmentation. No evidence of thrombus formation seen.
ARTERIAL DOPPLER
Subclavian, axillary & brachial arteries show fairly normal triphasic flow pattern. Radial and
ulnar arteries were patent showing biphasic flow pattern with high diastolic component.
Adequate flow is noted in distal arteries.
IMPRESSION:
Unremarkable Scan
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
USG Breast (L)
n
FINDINGS:-
Left Breast showed normal external appearances (Contours & Nipple)
Parenchymal tissue showed normal echoes in all the five compartments. No solid or cystic
mass was seen. Axillary tail also witnessed normal anatomy.
IMPRESSION:
Unremarkable Scan
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
RENAL ARTEIAL DOPPLER
n
FINDINGS:-
Normal anatomy was appreciated in both Kidneys.

The blood flow was seen in the entire renal contours upto the cortex bilaterally. On duplex
scanning there were slow upstrokes with low amplitude peaks bilaterally_ Tardus & Parvus
wave form.
Renal duplex criteria. Such criteria need to be established by the investigator as part of the study design. The
use of validated techniques and reporting standards is recommended whenever possible. Renal duplex sonography
(RDS) methods and reporting standards that deviate from these validated techniques should be described in detail.
Resistive indices may be predictive of outcomes and should be obtained. Examples of established RDS velocimetric
criteria for a >60% RAS, using a Doppler angle of ≤60 degrees, include direct criteria (>180 cm/s peak systolic
renal artery velocity, >3.5:1 renal artery to aortic peak systolic velocity ratio) and indirect criteria (tardus et
parvus pulse, rise time >0.07 seconds, difference in resistive index >0.15 between kidneys or evaluated segmental
arteries, loss of early systolic peak reflective wave complex).
IMPRESSION:
Renal Artery Stenosis
SUGGESTION:
Renal Angio/Clinical correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
DOPPLER LOWER EXTRIMITY (L)
n
FINDINGS:-
Femoral, Popliteal and Tibial vessels were examined on left side.
All the arteries were visualized showing normal blood flow in triphasic pattern. No evidence
of atherosclerosis was appreciated intraluminally.
Venous system showed normal compressibility with no internal echoes. Normal

augmentation was seen in the deep venous system. No evidence of DVT.
IMPRESSION:
Unremarkable Scan
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
DOPPLER LOWER EXTRIMITY (L)
n
FINDINGS:-
 Femoral, Popliteal and Tibial vessels were examined on the left side.
 All the veins were hypo echoic, distended, non compressible with internal
echoes. Thrombosed saphenofemoral junction was noticed as well. No blood flow was
seen in any of these veins. No wave form appreciated. IVC was normal, patent and
compressible with normal blood flow.
 All the arteries were visualized showing normal blood flow in triphasic pattern.
No evidence of atherosclerosis was appreciated intraluminally.
IMPRESSION:
DVT
SUGGESTION:
Venogram/Lab./Clinical correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
DOPPLER LOWER EXTRIMITY (R)
n
FINDINGS:-
Rt. Femoral, Popliteal and Tibial vessels were examined.
All the arteries were visualized with diffusely thickened intima media.
Normal color flow was seen in the Femoral artery; however dampened flow was appreciated
in distal arteries. Triphasic pattern was appreciated in the femoral; however loss of triphasic
flow pattern in the Popliteal & distal arteries.

IMPRESSION:
Arterial Sclerotic Change
SUGGESTION:
Angiography/Lab./Clinical correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Shazia BB Age 24 Years Date 18-02-2018
Examination DOPPLER LOWER EXTERIMITY (L)
REPORT:-
Multiple dilated (05mm_Normal Range Upto-04mm) slightly tortuous venous channels

were seen in the calf beneath the knee joint reflecting incompetent perforator between
the superficial and the deep veins.
The saphenofemoral and saphenopopliteal valves appear competent.
Femoral, Popliteal and Tibial vessels were examined.

Normal triphasic flow was seen in the arteries.
IMPRESSION: Varicose Veins (Boyd Perforator) region
SUGGESTION: CT Angio
Perforators Location:
Ankle (May/Kuster), Lower leg (Cockett), Below knee (Boyd), Above knee/distal thigh
(Dodd), Mid thigh/sartorial canal (Hunterian)
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name M. Ashraf Age 25 Years Date 06-11-2018
Examinatio
USG SCROTUM
n
FINDINGS:-
Both testes were normal in size, shape and outlines. No evidence of focal echogenic or echo
poor area is seen. No evidence of hydrocele or varicocele was seen. No epididymal
cyst/mass noticed.
Doppler imaging showed normal indices in extra/intra testicular vessels.
IMPRESSION:
Unremarkable Scan
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name M. Imran Age 25 Years Date 06-07-2018
DR # 1272 OPD/Indoor # 11735
Examinatio
USG SCROTUM
n
Report:-
Gray Scale Imaging:
Both testes are normal in size, shape and outlines. No evidence of focal echogenic or echo
poor area is seen. No evidence of hydrocele is seen. Multiple anechoic worm like structures
are seen on left side. No epididymal cyst or mass.
Colour Doppler Imaging:
Arteries (Supra/Intra testicular) show normal flow pattern. Left sided venous plexus showed
significant dilatation with gross augmentation on valsalva practice.
IMPRESSION:
Left sided Varicocele
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
USG CHEST
n
FINDINGS:-
Pleural recesses were approached laterally & inferoposteriorly on both sides. No evidence of
basal part air space disease or fluid collection in the pleural spaces was seen on either side.
IMPRESSION:
Unremarkable Scan
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name M. Azan Age 11 Months Date 01-11-2018
REPORT:-
 Scrotum showed a solitary testicle on right side with normal appearances. No

focal lesion/varicocele seen. A small hydrocele was also seen.
 Left testicle was noticed in the left inguinal canal.
IMPRESSION:
Left Undescended Testes (Inguinal)
SUGGESTIONS:
Signature
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Examinatio
USG SWELLING
n
FINDINGS:-
A small (28x21x25mm), oval shaped, partially mobile, smoothly contoured; relatively hyper
reflective mass was seen in subcutaneous plans along the superolateral compartment of left
buttock.
IMPRESSION:
Unremarkable Scan
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. SOBIA
Name Shahida Nadeem Age 30 Years Date 21-08-2013

Examinatio
USG OBS
n
REPORT:-
Placenta was fundo posterior. Longitudinal Lie (Cephalic)
BPD 93mm
HC 331mm
FL 68mm
AC 320mm
EFW 2873 Grams
GA 37+ Wks (Approx.)
Fetal Anotomy Details:
were normal. Transverse cerebellar diameter was 45mm. Abdominal wall was intact,
stomach showed normal situs. Kidneys and urinary bladder were normally visualized. No
skeletal dysplasia. Cervical canal measured 57mm and was competent.
Umbilical Artery showed:

RI_0.69, PI_1.06, S/D Ratio_3.20
No evidence of fetoplacental insufficiency.
Biophysical Profile:-
Placenta 02
Cardiac Activity 02
DR. Jamil U Rehman

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M.B.B.S, R.M.P

Breathing Movements 02
Amniotic Fluid 02
Tone 02
Gross Body Movements 02
Total 12/12
DR. Jamil U Rehman

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M.B.B.S, R.M.P

To DR.
Name M. Asghar Age 60 Years Date 12-02-2016

Examinatio
USG ANTERIOR URETHRA
n
REPORT:-
Penile urethra was examined by high frequency transducer.
All the three muscular pillars showed normal anatomical behavior. Normal appearing
cavernosal arteries & veins.
Urethral lumen was filled with lignocaine gel in reterograde fashion. All the visualized
lumen starting from navicular fossa to membranous level showed normal smooth
contours. No evidence of luminal scratch/tag was seen; however the dilated bulbar
showed narrowing at proximal borders. The membranous urethral narrowing might be the
result of stricture.
IMPRESSION: Normal Anterior Urethra
SUGGESTION: Lab./Clinical Correlation
DR. Jamil U Rehman

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M.B.B.S, R.M.P

To DR. KHALID MEHMOOD
Name Sakina BB Age 60 Years Date 03-03-2016
Examinatio
Doppler STUDY OF ABDOMINAL AORTA
n
TECHNIQUE: Multiplanar gray-scale/doppler imaging of the abdominal aorta was

performed using trans abdominal technique with convex transducer on esoate MyLabSeven
ultrasound machine.
FINDINGS:-
ON GRAY SCALE;
Abdominal aorta shows normal calibre with smooth wall pattern on grey scale till division
into two common iliac arteries. Patchy wall calcification was seen along its course. No
aneurysm was seen. Both mesenteric arteries (SMA and IMA) show normal openings from
the abdominal aorta.
ON COLOR DOPPLER;
Normal color flow is seen in the abdominal aorta, both the mesenteric & common iliac
arteries.
ON SPECTRAL ANALYSIS;
Normal wave pattern is seen in the abdominal aorta, mesenteric & common iliac arteries.
DR. Jamil U Rehman

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M.B.B.S, R.M.P

IMPRESSION: Sonographically Unremarkable Study
SUGGESTION: Clinical Correlation
DR. Jamil U Rehman

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M.B.B.S, R.M.P

To DR. GHAZANFAR BUKHARI
Name M. Anwar Age 45 Years Date 12-05-2014
Examinatio
PENILE DOPPLER
n
Report:-
Ultrasound examination of penile circulation was performed using gray scale imaging, color
doppler imaging and duplex waveform analysis. The examination was done in flaccid state.
Cavernosal Arterial Doppler Indices:
Right Peak Systolic Velocity 16 cm / sec
Inner Calibre 0.4 mm

Left Peak Systolic Velocity 14 cm / sec
Inner Calibre 0.3 mm
IMPRESSION:
Arteriogenic Impotence (Inflow Erectile Dysfunction)
SUGGESTION:
Angiogram/Clinical Correlation
Signature
DR. Jamil U Rehman

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M.B.B.S, R.M.P

Peak systolic velocity is the best doppler indicator of arteriogenic impotence. Its value < 30
cm/sec during the examination indicates arterial dysfunction. Some people consider less
than 25 cm/sec as definite arterial dysfunction and 25-30 cm/sec as borderline case.
DR. Jamil U Rehman

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M.B.B.S, R.M.P

To DR. AR GREWAL
Name Shan Age 45 Years Date 02-01-2016

Examinatio
LOWER EXTEREMITY DOPPLER (R)
n
REPORT:-
Rt. Femoral, Popliteal and Tibial vessels were examined.
All the arteries were visualized with diffusely thickened intima media.
Normal color flow was seen in the Femoral artery; however dampened flow was
appreciated in distal arteries.
Triphasic pattern was appreciated in the femoral; however loss of triphasic flow pattern in
the Popliteal & distal arteries.
Venous system showed normal compressibility with no internal echoes.
Normal augmentation was seen in the deep venous system.
No evidence of DVT.
IMPRESSION: Diffuse arterial sclerotic disease
DR. Jamil U Rehman

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M.B.B.S, R.M.P

To DR.
Name Akhtar BB Age 65 Years Date 15-11-2017
Examinatio
DOPPLER UPPER EXTRIMITY (L)
n
FINDINGS:-
Pulse pattern was irregularly irregular with changing pulse volume. Subclavian artery
showed normal triphasic pattern; however axillary & brachial arteries showed loss of
triphasic flow pattern with appreciable patchy longitudinal hypo reflective areas of irregular
margins & few of rounded fashion, along the arterial wall extraluminally leading to luminal
narrowing gradually down to the proximal radial & ulnar segments. Diminished color filling
was also noticed up to the proximal radial and ulnar segments. No flow was noted in distal
arteries; however, few collateral channels were noticed draining the extremity.
Subclavian, axillary & brachial veins showed patent lumens. No evidence of DVT seen.
SUGGESTION:
CT Angio
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. MUNIR AHMAD
Name Umme Habiba Age 45 Days Date 31-03-2014

Examinatio
USG HIP JOINTS (Bilateral)
n
REPORT:-
Very difficult task with irritable baby; however the appreciated sonogram showed:
Angle Normal Value Right Left
(NV >60)
Alpha 60o 300
(NV<55)
Beta 700 800
Calculated alpha and beta angles in coronal plane at both hip joints were beyond the
recommended limits and reflected the scenario of Developmental Dysplasia of Hips
bilaterally (> on Lt.).
There was poor patchy cartilaginous and osseous roofing of femoral heads. Poor contact and
non centering of femoral heads were seen. Tri-radiate cartilage showed existence; however
not intact. Clinical correlation/follow up is advised.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. AR GREWAL

Examinatio
CAROTID DOPPLER (4-Vessel Study)
n
REPORT:-
Rt. CCA shows a large (17.8mm) calcified plaque at the bifurcation extending into ICA
causing almost 76% Diameter stenosis. Lt. CCA also shows a large (14.7mm) calcified
plaque at the bifurcation extending into ICA causing almost 84% Diameter stenosis.
Vertebral arteries show forward flow pattern and normal Doppler indices.
IMPRESSION: Bilateral CCA Stenosis
SUGGESTION: CT Angio/Clinical Correlation
DR. Jamil U Rehman

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M.B.B.S, R.M.P

BILIARY ATRESIA
Epidemiology
It is thought to affect 1 in 10,000-15,000 newborn infants. There is a recognised male

predilection.
Clinical presentation
It precipitates within the first 3 months of life. Infants with biliary atresia may appear
normal and healthy at birth. Most often, symptoms develop between two weeks to two
months of life, and may include : jaundice, Dark yellow or brown urine, Pale or clay-
colored (acholic) stools, Hepatomegaly
Radiographic features
Ultrasound:
Echogenic triangular cord sign, Larger hepatic arterial calibre, gallbladder ghost triad
Nuclear medicine (hepatobiliary (HIDA) scan)
Tc-99m diosgenin (DISIDA) and mebrofenin (BRIDA) have highest hepatic extraction rate
and shortest transit time of hepatobiliary radiotracers. Cases of biliary atresia typically
demonstrate relatively good hepatic uptake with no evidence of excretion into the bowel at
24 hours. Pretreatment with phenobarbital (5 mg/kg/day for 5 days) to increase biliary
secretion by stimulating hepatic enzymes is freqeuently helpful to minimize the possibility of
a false-positive study in a patient with a patent biliary system but poor excretion.
Complications
Portal hypertension
DR. Jamil U Rehman

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M.B.B.S, R.M.P

Treatment and prognosis
Kasai portoenterostomy, Liver transplantation
Differential diagnosis
General imaging differential considerations include
 Neonatal hepatitis
 Alagille syndrome
 Caroli disease
 Bile plug syndrome
 Lipid storage disorders
TRIANGULAR CORD SIGN
 Dr Bruno Di Muzio and Dr MT Niknejad et al.

 The triangular cord sign is a triangular or tubular echogenic cord of fibrous
tissue seen in the porta hepatis at ultrasonography and is relatively specific in the
diagnosis of biliary atresia.
 This sign is useful in the evaluation of infants with cholestatic jaundice,
helping for the differential diagnosis of biliary atresia from neonatal hepatitis.
 Thickness of the echogenic anterior wall of the right portal vein (EARPV)
measured with more than 4 mm on a longitudinal USG scan define the triangular
cord sign2.
DR. Jamil U Rehman

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M.B.B.S, R.M.P


DR. Jamil U Rehman

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M.B.B.S, R.M.P


 Presence of triangular cord sign
DR. Jamil U Rehman

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M.B.B.S, R.M.P


 Schematic drawing represents the anatomic relationship between the fibrous

ductal remnant and blood vessels around the porta hepatis. The triangular, cone-
shaped, fibrous ductal remnant (black arrowheads, green) is positioned anterior and
slightly superior to the portal vein (long arrow, blue) and the hepatic artery (short
arrow, red).
GALLBLADDER GHOST TRIAD
Dr Bruno Di Muzio and Dr Venkatesh Manchikanti et al.
Gallbladder ghost triad is a term used on ultrasound studies when there is a combination
of three gallbladder features on biliary atresia:
 Length less than 19 mm
 Irregular or lobular contour
DR. Jamil U Rehman

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M.B.B.S, R.M.P

 Lack of smooth/complete echogenic mucosal lining with an indistinct wall
DR. Jamil U Rehman

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M.B.B.S, R.M.P

To DR. AR GREWAL
Name Shan Age 12 Days Date 01-01-2015

Examinatio
USG HIP JOINTS
n
REPORT:-
Calculated alpha and beta angles in coronal plane at both hip joints were beyond the
recommended limits and reflected the scenario of Developmental Dysplasia of Hips
bilaterally (> on Lt.).
There was poor patchy cartilaginous and osseous roofing of femoral heads. Poor contact
and non centering of femoral heads were seen. Tri-radiate cartilage showed existence;
however not intact. Clinical correlation/follow up is advised.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

IMPRESSION: Bilateral DDH
SUGGESTION: Clinical Correlation/Follow UP
DR. Jamil U Rehman

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M.B.B.S, R.M.P

To DR. MUNIR AHMAD
Name Umme Habiba Age 45 Days Date 04-06-2016

Examinatio
n
REPORT:-

(NV >60)
Alpha 63o 640
(NV<55)
Beta 490 530
Calculated alpha and beta angles in coronal plane at both hip joints are within recommended
limits and equate with Graph type I. No sonographic evidence of CDH at present. There is
good cartilaginous and osseous roofing of femoral heads. Normal contact and centering of
femoral head is seen. Tri-radiate cartilage is intact. If clinical suspicion is still high then
follow up is advised at 03 months.
DR. Jamil U Rehman

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M.B.B.S, R.M.P

DR. Jamil U Rehman
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M.B.B.S, R.M.P

To DR.
Name Sher Afzal Age 34 Years Date 23-11-2014
Examination HEPATIC DOPPLER (Transplanted Liver)
REPORT:
Patent portal vein showed hepatopetal flow with normal peak systolic velocity.
Hepatic veins appeared normal & showed normal phasicity with respiration.
Hepatic artery showed normal resistive and pulstality indices.
IMPRESSION:
Unremarkable Study
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. M. ASIF ASHRAF
Name M. Idrees Age 35 Years Date 29-02-2016
Examinatio
USG SCROTUM
n
REPORT:-
Gray Scale Imaging:
Right Testicle (45x39mm) was enlarged with diffuse edema. No focal lesion seen.
Epididymus also showed diffuse edema. No evidence of hydrocele or varicocele was seen.
Significant free fluid was also seen surrounding the nut.
Left Testicle (32x17mm) was normal in size, shape and outlines. No evidence of focal
echogenic or echo poor area is seen. No evidence of hydrocele or varicocele was seen. No
epididymal cyst or mass.
Doppler Imaging:
Rich blood flow was seen in the right supra/intra testicular vessels.
Normal blood flow with good spectral waveform was seen in the left supra/intra testicular
vessels.
IMPRESSION:
Right Epididymo Orchitis
DR. Jamil U Rehman

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M.B.B.S, R.M.P

SUGGESTIONS:
DR. Jamil U Rehman

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M.B.B.S, R.M.P

To DR. FOUZIA BASHARAT
Name Nargis BB Age 38 Years Date 21-01-2014

Examinatio
USG OBS (Anomaly Scan)
n
REPORT:-
Single intrauterine fetus having good cardiac activity & body movements was noted. Liquor
was in plenty & dirty (AFI_212mm). Placenta was fundo posterior & Rt. Lateral. Longitudinal
Lie (Cephalic).
BPD 109mm
HC 379mm
FL 65mm
AC 291mm
EFW 2671 Grams
Normal 3-vessel umbilical cord with single loop encircling the neck. Normal cardiac 4
chamber view. Brain showed grossly dilated ventricular channels, compressing the
parenchyma aside. Spine was normal. Abdominal wall was intact. Stomach showed normal
situs. Gut showed non echogenic (normal) appearance. Kidneys and urinary bladder were
normally visualized. No skeletal dysplasia. Cervical canal measured 56mm and was
competent. Umbilical artery showed: PI_0.63, RI_0.46, S/D Ratio_1.85. No fetoplacental
insufficiency.
IMPRESSION:
CAN/Hydrocephalus
SUGGESTIONS:
Signature
DR. Jamil U Rehman

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M.B.B.S, R.M.P

Causative Associations:
Commoner and reported in more than 80% of cases:
Aqueductal Stenosis, Chiari Malformations, Neural tube defect(s), Dandy-Walker
Malformation, Encephalocoele, Alobar holoprosencephaly, Posterior fossa cysts,
Polymicrogyria
To DR. NAEEM SIDDIQUI
Name M. Zia Age 27 Years Date 02-02-2016

Examinatio
USG BREAST (R)
n
REPORT:-
A small, mobile, tender hypo reflective nodule, surrounded by a disc like mound of hyper
reflective tissue in sub areolar plans was seen. No evidence of any calcification was seen.
Axilla showed normal anatomical behavior. No lymphadenopathy noticed.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

IMPRESSION: Gynecomastia
SUGGESTION: Lab./Clinical Correlation/Mammography
Fetal hydrocephalus
Dr Yuranga Weerakkody et al.
Fetal hydrocephalus often refers to an extension of fetal ventriculomegaly where

theventricular dilatation is more severe. It is usually defined when the
fetal lateralventricular diameter is greater than 15 mm 1.
Epidemiology
The estimated incidence is at ~ 0.5-3 % per 1000 live births. There may be a very slight
increased female predilection 10.
Pathology
DR. Jamil U Rehman
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M.B.B.S, R.M.P

It can be either obstructive or non obstructive and each can arise from a number
aetiologies. It a small proportion of cases it carries a familial X linked inheritence :congenital
X linked hydrocephalus
Causes
 in utero infection(s)
Associations
The vast majority of of conditions are are associated with other intra and cranial
anomalies 5. The list includes
 central nervous system anomalies : commoner 6 and reported in more than 80% of
cases
o aqueductal stenosis : one of the commonest causative associations
o Chiari malformations
o neural tube defect(s)
o Dandy-Walker malformation
o encephalocoele
o alobar holoprosencephaly
o posterior fossa cysts
o polymicrogyria
 non central nervous system anomalies
o craniofacial
 cleft lip +/ - palate
 low set ears
 bilteral optic atrophy
 facial bone anomalies
 acrocephalosyndactylies
o congenital cardiovascular anomalies
o gastrointestinal anomalies
o genitourinary anomalies
 congenital renal fusion
o skeletal anomalies
 clubfeet
 syndromes
o Meckel-Gruber syndrome 10
o Miller-Dieker syndrome 10
 chromosomal anomalies : may be present in ~ 20% of cases 10
DR. Jamil U Rehman

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M.B.B.S, R.M.P

o trisomy 21 7
o triploidy 7
See also : congenital syndromes associated with enlarged ventricles
Radiographic features
Antenatal ultrasound
Will demonstrate enlarged ventricles with variable degrees of parechymal thinning. The
choroid may seen floating within the ventricle giving a dangling choroid sign. Often a
separation of more than 3 mm between the choroid plexus and the margin of the ventricle
in considered abnormal. In some cases, there may also be evidence ofmacrocephaly.
Treatment and prognosis
The overall prognosis with depend in the underlying cause and associated anomalies. Some
cases can slowly progress during the fetal period. Antenatal shunting has been considered in
a small proportion of selected cases 2.
DR. Jamil U Rehman

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M.B.B.S, R.M.P

To DR. SAJID MUSTAFA
Name Ali Asghar Age 05 Months Date 08-03-2016
Examinatio
USG BRAIN
n
REPORT:-
Brain parenchyma showed significant compression against the skull (Max. Thickness_14mm
& Minimal thickness_07mm) secondary to grossly dilated ventricular channels down to 3 rd
ventricle with minimally dirty echoes. No evidence of choroid tumor seen. No mid line shift
appreciated.
IMPRESSION:
Hydrocephalus secondary to inflammatory insult
SUGGESTIONS:
CECT
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. AR GREWAL
Name Shan Age 12 Days Date 01-01-2015

Examinatio
USG HIP JOINTS
n
REPORT:-
Calculated alpha and beta angles in coronal plane at both hip joints are within
recommended limits and equate with Graph type I. No sonographic evidence of CDH at
present. There is good cartilaginous and osseous roofing of femoral heads. Normal contact
and centering of femoral head is seen. Tri-radiate cartilage is intact. If clinical suspicion is
still high then follow up is advised at 03 months.
IMPRESSION: Unremarkable Study
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

Name M. Luqman Age 35 Days Date 26-02-2014

Examinatio
USG ABDOMEN
n
REPORT:-
Hepatobilliary system, Pancreas, Spleen & Kidneys were unremarkable.
UB was empty.
Stomach was distended containing fluid/food debris. A beak of fluid was noted from
stomach lumen towards the antrum secondary to thickened pyloris muscularis reflecting
typical cervix sign with transverse thickness (15mm) & longitudinal thickness (18mm)_
“Hypertrophic Pyloric Stenosis”
No pleural effusion / ascites.
IMPRESSION:
HPS
SUGGESTION:
Ba Study/Clinical Correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. ASIM IKRAM
Name Sultan Age 40 Days Date 12-05-2015

Examinatio
USG SCROTUM
n
REPORT:-
Both testes were normal in size, shape and outlines. No evidence of focal echogenic or
echo poor area is seen. No epididymal cyst or mass. No evidence of varicocele was seen.
Normal blood flow with good spectral waveform was seen in both the supra/intra
testicular vessels. A large encysted area is seen surrounding the left testicle without
internal echoes.
IMPRESSION: Left Sided Hydrocele
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

Name Ammara Hussnain Age 02 Months Date 08-03-2016
Examinatio
USG BRAIN
n
REPORT:-
Brain parenchyma showed significant compression against the skull (Max. Thickness_11mm
& Minimal thickness_05mm) secondary to grossly dilated ventricular channels. No evidence
of choroid tumor seen. No mid line shift appreciated.
IMPRESSION:
Hydrocephallus
SUGGESTIONS:
CECT
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. SHAFIQ UR REHMAN LANGRIAL
Name Sumaira Age 05 Months Date 24-03-2014

Examinatio
USG ABDOMEN
n
REPORT:-
Liver showed homogeneous echo texture with smooth surface. No focal lesion or dilated
ducts seen. GB was normal. Visualized Pancreas showed normal reflectivity & contours.
Spleen was normal. Kidneys showed normal echoe pattern. No calculus or hydronephrosis
seen on either side. UB was normal. Multiple, edematous, dilated, fluid/food debris filled,
small gut loops were seen in the central/lower abdomen secondary to a complex echo mass
showing Pseudo Kidney appearance in LIF. No pleural effusion. Significant amount of inter
loop fluid was seen too.
IMPRESSION:
(Large Gut) Intussusception (Intussuscepient_35mm & Intussusceptum_18mm)
SUGGESTION:
Lab./CECT/Clinical Correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. AR GREWAL
Name M. Yousaf Age 45 Years Date 01-01-2014
Examinatio
DOPPLER USG IVC & TRIBUTARIES
n
Report:-
Gray Scale Imaging:
 Both Femoral, Common Iliac & Renal Veins showed normal appearances.
 Splenic & Superior Mesenteric Veins also showed normal appearances.
 IVC lumen showed normal calibre without any abnormal dilatation or

thrombus.
 All the veins showed normal color flow pattern.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To Dr.
Name M. Nazeer Age 46 Years Date 29-06-2016
Examinatio
DOPPLER USG IVC
n
FINDINGS:-
Grey scale imaging showed a large elongated echogenic mass intraluminally, starting from
the common iliac vein entry & extending upto the IVC entry in liver.
CFI confirmed the presence of mass partly obscuring the IVC lumen, upto its entry in the
Liver.
IMPRESSION:
Thrombus in the IVC
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. KHALIL AHMAD
Name Manzoor Hussain Age 65 Years Date 07-12-2013

Examinatio
USG Rt. KNEE JOINT
n
REPORT:-
Quadriceps tendon, Suprapatella bursa, Patellar tendon, Medial meniscus & Lateral
Meniscus were appreciated with slightly edematous joint capsule (Synovium). No collection
was noticed in the joint space. Popliteal artery and vein showed normal blood flow pattern.
No cystic/solid lesion seen in the popliteal fossa.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. AMJAD MEHMOOD KHAN
Name Khalid Mehmood Age 60 Years Date 20-02-2016

Examinatio
USG KNEE JOINT (R)
n
REPORT:-
Gross amount of dirty fluid was seen in the pre pattelar region anteriorly distorting the
joint capsule, extending along the lateral & medial compartments. The joint space also
showed few bony particles. Popliteal fossa showed normal anatomical behavior.
IMPRESSION: Unremarkable Scan
SUGGESTION: CECT/MRI/Clinical Correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. M. ALI YASEEN

Examinatio
USG CHEST
n
REPORT:-
Both lungs showed basal part air space disease (Consolidation).

No pleural effusion was seen on either side.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

Report:-
Rt. Kidney 78x40x10mm (Cortical Thickness)

Lt. Kidney 78x40x09mm (Cortical Thickness)
Kidneys showed increased echogenicity of the renal medulla (the pyramids are normally
hypoechoic to cortex). This appearance is typical of medullary nephrocalcinosis.
UB was full & showed significant sludge with diffuse wall thickening (09mm).
No pleural effusion/Ascites.
Signature Dated: 16-01-2013
Medullary nephrocalcinosis has many causes. The most common causes are hyperparathyroidism, renal tubular
acidosis, and medullary sponge kidney. Rarer causes of medullary nephrocalcinosis are papillary necrosis,
hypercalcaemia, hypercalciuria, prematurity, and primary hyperoxaluria.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. HUMA BASHIR
Name Rukhsana Nasir Age 33 Years Date 15-06-2015

Examinatio
USG OBS
n
REPORT:-
Placenta was posterior & high. Longitudinal Lie (Cephalic).
Growth Parameters:
GA_33+ Weeks
Normal 3-vessel umbilical cord, normal cardiac 4 chamber view. Neural axis including
spines were normal. Transverse cerebellar diameter was 35mm. Abdominal wall showed
defect through which liver & stomach protruded out. Kidneys and urinary bladder were
normally visualized. Cervical canal measured 58mm and was competent.
UMBILICAL ARTERY Doppler showed normal doppler indices. No evidence of

IMPRESSION: Omphalocele (An omphalocele is an abdominal wall defect in which

a variable amount of the abdominal contents protrude into the base of
the umbilical cord. The parietal peritoneum covers the extruded
DR. Jamil U Rehman

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M.B.B.S, R.M.P

abdominal wall contents)
To DR.
Name Rana Abbas Age 60 Years Date 27-06-2015

Examinatio
USG ABDOMEN
n
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

REPORT:-
Liver (span 189mm_Normal Range up to- 160mm ) was enlarged & showed fatty change. No
focal lesion or dilated ducts seen. GB was normal. CBD (04mm) & PV (12mm) showed
normal calibers. Pancreas showed hypo reflectivity with edematous contours. No peri
pancreatic collection/free fluid seen. Spleen (101mm_ Normal Range up to- 120mm ) was
normal. Kidneys showed normal echoe pattern. No calculus/hydronephrosis seen on either
side. UB was partially filled. No pleural effusion /ascites.
IMPRESSION: Hepatomegaly/Acute Pancreatitis
To DR. AR GREWAL
Name Gh. Farid Age 30 Years Date 10-03-2014
Examinatio
PENILE DOPPLER
n
Report:-
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

Ultrasound examination of penile circulation was performed using gray scale imaging, color
Doppler imaging and duplex waveform analysis.
Flaccid state
Right peak systolic ? cm / sec
Caliber ? mm
Left peak systolic ? cm / sec
Caliber ? mm
A few venous channels of very low velocity blood flow seen.
Post-Injection
No gross anatomical deformity on pre and post injection phase
No plaques seen on tunica.
Tuminency (Grade-?)
Rigidity ?Firm
Right peak systolic velocity is ? cm / sec
Caliber ? mm
Left peak systolic velocity is ? cm / sec
Caliber ? mm
Diastolic flow is ? cm / sec
No blood flow is seen in the veins through out erection.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

Name Liaqat Ali Age 55 Years Date 10-03-2014
Examinatio
USG PENILE SHAFT
n
Report:-
All the three muscular pillars of penile shaft showed normal anatomical appearance;
surrounding the penile urethra. Few patchy calcified plaques (nodular shaped) were
appreciated in the sheaths covering the corpora cavernosa and tunica albugenia bilaterally.
The cavernosal vessels showed normal Doppler flow pattern.
IMPRESSION: Peyronie Disease
SUGGESTION: Clinical Correlation/Follow Up
Signature
Peyronie disease (PD) is a relatively uncommon disorder characterized by the development of a fibrous plaque or
scar in the fibrous sheaths covering the corpora cavernosa and tunica albuginea of the penis. This inelastic area
usually does not permit lengthening of the effected surface during erection, causing the erect penis to bend in its
direction, leading to erectile dysfunction. The bend of the penis results in a deformity known as a chordee. The
disease, also called induratio penis plastica, was first described in 1743 by the French surgeon François Gigot de la
Peyronie.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. AR GREWAL

Examinatio
PORTAL VENOUS DOPPLER
n
REPORT:-
Patent Portal vein showed hepatopetal flow with normal peak systolic velocity. Splenic
vein and splenoportal confluence also appeared normal. Hepatic veins appeared normally
draining into IVC and showed normal phasicity with respiration.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. AR GREWAL

Examinatio
RENAL ARTERIAL DOPPLER
n
REPORT:-
Normal anatomy was appreciated in both Kidneys.
The blood flow was seen in the entire renal contours upto the cortex bilaterally.
On duplex scanning there were slow upstrokes with low amplitude peaks bilaterally_
Tardus & Parvus wave form.
Renal duplex criteria. Such criteria need to be established by the investigator as part of the study design. The
use of validated techniques and reporting standards is recommended whenever possible. Renal duplex
sonography (RDS) methods and reporting standards that deviate from these validated techniques should be
described in detail. Resistive indices may be predictive of outcomes and should be obtained. Examples of
established RDS velocimetric criteria for a >60% RAS, using a Doppler angle of ≤60 degrees, include direct
criteria (>180 cm/s peak systolic renal artery velocity, >3.5:1 renal artery to aortic peak systolic velocity ratio)
and indirect criteria (tardus et parvus pulse, rise time >0.07 seconds, difference in resistive index >0.15
between kidneys or evaluated segmental arteries, loss of early systolic peak reflective wave complex).
IMPRESSION: Bilateral Renal Artery Stenosis
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. AR GREWAL
Name Asia Perveen Age 30 Years Date 01-01-2014
Examinatio
RENAL DOPPLER (TRANSPLANTED KIDNEY)
n
REPORT:-
ON GRAY SCALE:
The Kidney was noted in RIF & measured about 97x39x16mm. The renal outlines were
smooth. No stone, cyst, hydronephrosis or mass seen. The corticomedullary differentiation
was preserved.
ON CONVENTIONAL COLOR AND COLOR AMPLITUDE:
The kidney showed good flow upto the cortex. No focal area devoid of flow in the
transplanted kidney visualized. The blood flow was visualized in renal artery and renal vein.
ON DUPLEX SCANNING:
There was forward both systolic and diastolic flow observed.
Vmax was ? cm / sec
Vmin was ? cm / sec
The Resistive Index is ? (Normal 0.50 to 0.70)
IMPRESSION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

Unremarkable Scan
SUGGESTIONS:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name M. Saeed Age 45 Years Date 08-04-2014
Examinatio
USG SCROTUM
n
REPORT:-
Gray Scale Imaging:
 Both testes were normal in size, shape and outlines. No evidence of focal
echogenic or echo poor area is seen.
 No evidence of hydrocele or varicocele was seen.
 No epididymal cyst.
 A huge (46x19mm) ill defined hyper reflective mass was noted in the left
hemi scrotum in the base with appreciable rounded (11mm) small focus with
calcified rim, pushing the testicle superiorly towards neck.
Doppler Imaging:
 Normal blood flow with good spectral waveform was seen in both the
supra/intra testicular vessels.
IMPRESSION:
Lt. Scrotal Mass (Adenomatoid Tumor)
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

SUGGESTIONS:
Signature
Adenomatoid tumours of the scrotum are benign, solid extratesticular lesions that can originate from the
epididymis, tunica vaginalis, or spermatic cord(90% derived from the funiculus).
Epidemiology
They are the most common extratesticular neoplasm, and most common tumour of the epididymis, and occur more
often in the lower pole than in the upper pole by a ratio of 4:1.
Clinical presentation
Usually an incidental finding, adenomatoid tumors manifest as a small (usually under 2 cm)painless scrotal mass,
with the majority diagnosed in patients aged 20 - 50 years. They are typically unilateral and occur more frequently
on the left side.
When they grow non-invasively into the testicular parenchyma, they can simulate intratesticular disease.
Differential diagnosis
General imaging differential considerations include:
 Testicular lipoma
 Testicular rhabdomyosarcoma
 Testicular liposarcoma
 Supernumerary testes(a rare condition in which more than
two testes are present)
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

DR. Jamil U Rehman
NOT VALID FOR COURT
M.B.B.S, R.M.P

Name Sajida Perveen Age 49 Years Date 24-02-2016

Examinatio
USG SHOULDER JOINT (R)
n
REPORT:-
The appreciable joint capsule showed intact contours. Normally placed gliding tendon of
the biceps in the inter tubercular groove of humorous anteriorly. The muscles of rotator
cuff showed normal anatomical appearance, even during mobility of joint. No evidence of
joint effusion or joint subluxation seen.
IMPRESSION: Sonographically Unremarkable Study
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. NADEEM
Name M. Affan Age 02 Months Date 03-04-2015

Examinatio
USG BRAIN
n
REPORT:-
Brain parenchyma showed normal appearances with slight compression effect secondary
to crescent shaped fluid collections in sub dural territories bilaterally. A significant
subcutaneous collection was also seen on Rt. Side. No focal lesion/mid line shift
appreciated. Ventricular system appeared normal.
IMPRESSION: Sub Dural Effusion
SUGGESTION: MRI/Clinical Correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. SHAFIQ UR REHMAN LANGRIYAL
Name Muzammil Kiran Age 22 Years Date 14-01-2016

Examinatio
USG SWELLING
n
REPORT:-
A small (28x21x25mm), oval shaped, partially mobile, smoothly contoured, relatively

hyper reflective mass was seen in subcutaneous plans along the superolateral
compartment of left buttock.
IMPRESSION: Lipoma?
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. AR GREWAL
Name Nadeem Khan Age 30 Years Date 01-01-2014
Examinatio
SCROTAL DOPPLER
n
REPORT:-
GRAY SCALE IMAGING:
Rt. Testes showed increased size with hypo reflectivity reflecting edema. The testicular
appendix measured 11.7mm (normal range upto_ 5.6mm) reflected edema/twist. Lt. testes
was normal in size, shape and outlines. No evidence of focal echogenic or echo poor area is
seen. No evidence of hydrocele or varicocele is seen. No epididymal cyst or mass.
COLOUR DOPPLER IMAGING:
Color flow imaging reflected the diminished flow pattern on Rt. Side. Normal blood supply is
seen to the Lt. testes. Arteries (Supra/Intra testicular) show normal flow pattern. Venous
plexus show normal appearances.
IMPRESSION:
Rt. Testicular Torsion
SUGGESTIONS:
MRI/Clinical Correlation
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. FAREEHA
Name Shakila Babar Age 25 Years Date 15-06-2015
Examination USG OBS
REPORT:-
Mono Chorionic Tri Amniotic Triplet Alive Pregnancy was noted. Good cardiac activity seen in
all the fetuses. Placenta was anterior & high. Liqour was adequate in all sacs. Internal os
was competent & cervical length measured 46mm.
Fetus A Fetus B Fetus C
Breech Lie Cephalic Lie Cephalic Lie
BPD 84mm BPD 80mm BPD 81mm
HC 293mm HC 287mm HC 299mm
FL 62mm FL 57mm FL 62mm
AC 264mm AC 250mm AC 278mm
1826 1504 1913

EFW EFW EFW
Grams Grams Grams
GA 32+ Wks GA 30+ Wks GA 32+ Wks
All the fetuses showed normal neural axis with spines, GITs, GUTs & MSK systems. No
obvious congenital anomaly seen at present. Umbilical arterial doppler showed normal
indices in all the fetuses. No evidence of fetoplacental / uteroplacental insufficiency.
IMPRESSION:
Unremarkable Scan
SUGGESTIONS:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

DR. Jamil U Rehman
NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. M. ALI YASEEN
Name Bashir Ahmad Age 60 Years Date 23-02-2016

Examinatio
USG PROSTATE (TRUS)
n
REPORT:-
Scan was performed by high frequency transrectal transducer on myLab Seven.
Prostate (46Grams) was enlarged with irregular contours. The median lobe was seen
projecting in the lumen. Two to three tiny parenchymal cysts were also seen
accompanying tiny calcific foci. The echogenic prostatic capsule showed appreciable
distortion.
IMPRESSION: Enlarged Prostate with Irregular Contours & Tiny Cysts
SUGGESTION: PSA/TRUS Guided Biopsy Correlation
Cysts of the prostate are related to atrophy of the prostate gland as well as to other well-known factors, such as
inflammatory disease, benign prostatic hyperplasia, ejaculatory duct obstruction and cancer.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

DR. Jamil U Rehman
NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. AMINA SARWAR
Name Shakila Perveen Age 40 Years Date 02-03-2016

Examinatio
USG Pelvis (TVS)
n
TECHNIQUE: Multiplanar gray-scale imaging of the pelvis was performed using

transvaginal technique with 120 degree high frequency TVS transducer on esoate
MyLabSeven ultrasound Machine.
FINDINGS:-
Anteverted uterus measured 89x43x52mm and showed central echo endometrial canal
with thickness 06mm. No evidence of intrauterine mass was seen. Both ovaries showed
normal anatomy. No adnexal mass seen. No free fluid was seen in the pelvis.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

DR. Jamil U Rehman
NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Bushra BB Age 37 Years Date 27-12-2018
Examination USG OBS
REPORT:-
Di Chorionic Di Amniotic Twin Alive Pregnancy was noted. Good cardiac activity seen in all
the fetuses. Liquor was adequate in both sacs. Internal os was competent & cervical length
measured 51mm.
Fetus A Fetus B
Placenta was Anterior Placenta was Posterior
Breech Breech
BPD 85mm BPD 87mm
FL 62mm FL 62mm
AC 263mm AC 292mm
EFW 1756 Grams EFW 2119 Grams
GA 33+ Wks GA 34+ Wks
No obvious congenital anomaly seen at present.
IMPRESSION:
Unremarkable Scan
SUGGESTIONS:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. ANJUM SHAHEEN
Name Humaira BB Age 28 Years Date 12-10-2013
Examination USG OBS
REPORT:-
Mono Chorionic Di Amniotic twin pregnancy was noted. Good cardiac activity was seen in
Fetus A, while poor cardiac activity was seen in Fetus B. Liqour was in plenty (AFI_211mm)
in Fetus “A’ Sac & NIL in Fetus “B” Sac. Placenta was fundo posterior & Lt. Lateral. Fetus B
was noted, stuck against the anterior wall in lower uterine segment. Internal os was
competent & measured 42mm.
Fetus A Fetus B
Presentation Breech Presentation Breech
BPD 56mm BPD 42mm
HC 200mm HC 187mm
FL 40mm FL 38mm
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

AC 184mm AC 164mm
EFW 571 Grams EFW 416 Grams
GA 23 +Wks GA 20 +Wks
Fetus “A” seemed to be fit; however Fetus “B” showed compressed skull & body against the
uterine wall. Feature are consistent with Twin to Twin Transfusion Syndrome_Stage III,
(Fetus “A” _ Recepient & Fetus “B”_ Miserable Donor)
TTTS is staged as follows:
 Stage I - The bladder in the donor twin is still visible.
 Stage II - The bladder in the donor twin is no longer visible, but no critically abnormal findings are
observed on Doppler studies.
 Stage III - Doppler studies are critically abnormal.
 Stage IV - Hydrops is present.
 Stage V - The demise of 1 or both twins has occurred.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name M. Abid Age 18 Years Date 06-03-2017
Examination USG SCROTUM
REPORT:-
 Scrotum showed solitary left side testicle (32x26mm) with normal

appearances. No focal lesion seen.
 Right testicle (26x19mm) was sen in the inguinal canal.
IMPRESSION:
Rt. Undescended Testes (Inguinal)
SUGGESTIONS:
Clicical correlation
Signature
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

DR. Jamil U Rehman
NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. AR GREWAL

Examinatio
CAROTID DOPPLER (4-Vessel Study)
n
REPORT:-
Rt. CCA showed a large (17.8mm) calcified plaque at the bifurcation extending into ICA
causing almost 76% Diameter stenosis. Lt. CCA & ICA showed normal flow pattern &
doppler indices. Both ECA & Vertebral arteries showed normal flow pattern and doppler
indices too.
Carotid Artery Stenosis Levels:
 No Stenosis
 <50% Stenosis
 50%-70% Stenosis
 >70% Stenosis
 Near Occlusion
 Total Occlusion
IMPRESSION: Rt. Carotid Artery Stenosis
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. KHALID MAQSOOD
Name Eishal Fatima Age 12 Days Date 31-03-2014

Examinatio
n
REPORT:-
Very difficult task with irritable baby; however the appreciated sonogram showed:
(NV >60)
Alpha 47o 640
(NV<55)
Beta 420 500
Calculated alpha and beta angles in coronal plane at Rt. Hip joint were beyond the
recommended limits and reflected the scenario of Developmental Dysplasia of Hip.
There was poor patchy cartilaginous and osseous roofing of femoral head. Poor contact and
non centering of femoral head was seen. Tri-radiate cartilage showed existence; however
not intact. Clinical correlation/follow up is advised.
Calculated alpha and beta angles in coronal plane at Lt. Hip joint were within normal limits.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name M. Usman Age 46 Years Date 10-03-2014
Examinatio
USG PENIS
n
Report:-
Grey Scale Ultrasound examination of penis showed normal anatomical appearances along
the muscle plans. Penile Urethra showed mild edema in patchy fashion in proximal & distal
third segments. Penile arterial & venous circulations appeared normal on color flow imaging
and duplex waveform analysis.
IMPRESSION: Urethritis
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. ASHFAQ HUSSAIN
Name Zahida Perveen Age 50 Years Date 08-11-2015

Examinatio
USG EYE (R)
n
REPORT:-
(Ocular USG was performed by high frequency linear array transducer)
Both the chambers & Lens were well appreciated. A small echogenic focus was
appreciated in the corneal plans. Anterior & posterior chambers showed normal echo free
appearances with smooth contours. No evident foreign body or retinal detachment seen.
Lens showed normal equilibrium of suspension along the ciliary bodies. Appreciable
echoes along the both (Anterior & posterior) capsules & body were noticed reflecting cataract
process.
IMPRESSION: Corneal Ulcer (Inflammatory Change)/Cataract
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. NAEEM AKHTAR
Name Mehboob Hussain Age 43 Years Date 14-04-2014

Examinatio
USG Lt. Leg (Posterior Compartment)
n
REPORT:-
Grey scale sonography showed the posterior compartment of left leg in normal fashion. No
evidence of any collection/edema seen in the posterior compartment. Normal appearing
Achilles Tendon in transverse & longitudinal plans. No evident tear/rupture appreciated in its
course to the soleus/gastrocnemius access.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. ASMA YASIR
Name Kousar Akram Age 28 Years Date 18-05-2015

Examinatio
USG Pelvis
n
REPORT:-
“Y” shaped uterus with two fundi, united at cervical level with two EM canals was seen. No
evidence of intrauterine GS/RPOCs/mass was seen on either side. No adnexal mass seen.
No free fluid was seen in the pelvis.
IMPRESSION: Uterus Didelphys
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name M. Imran Age 25 Years Date 06-11-2018
DR # 1272 OPD/Indoor # 11735
Examinatio
USG SCROTUM
n
REPORT:-
Gray Scale Imaging:
Both testes are normal in size, shape and outlines. No evidence of focal echogenic or echo
poor area is seen. No evidence of hydrocele is seen. Multiple anechoic worm like structures
are seen on left side. No epididymal cyst or mass.
Arteries (Supra/Intra testicular) show normal flow pattern. Left sided venous plexus showed
significant dilatation with gross augmentation on valsalva practice.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

IMPRESSION:
Left sided Varicocele
SUGGESTION:
GRADING OF VARICOCELE
Grade 1: No dilated intrascrotal veins, Reflux in spermatic cord veins of the inguinal region during Valsalva
maneuver
Grade 2: Prominent veins at upper pole of testis, Reflux at upper pole veins during Valsalva maneuver
Grade 3: No major dilatation in supine position, Dilated veins upto lower pole of testis seen only in standing
position, Reflux at lower pole veins during Valsalva maneuver
Grade 4: Dilated veins even in supine position, Reflux during Valsalva maneuver
Grade 5: Dilated veins, Reflux without Valsalva maneuver
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Shazia BB Age 24 Years Date 06-11-2018
Examination DOPPLER LOWER EXTERIMITY (L)
REPORT:-
Multiple dilated (05mm_Normal Range Upto-04mm) slightly tortuous venous channels

were seen in the calf beneath the knee joint reflecting incompetent perforator between
the superficial and the deep veins.
The saphenofemoral and saphenopopliteal valves appear competent.
Femoral, Popliteal and Tibial vessels were examined.

Normal triphasic flow was seen in the arteries.
IMPRESSION: Varicose Veins (Boyd Perforator) region
Perforators Location:
Ankle (May/Kuster), Lower leg (Cockett), Below knee (Boyd), Above knee/distal thigh
(Dodd), Mid thigh/sartorial canal (Hunterian)
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Saima Zahid Age 20 Years Date 09-11-2018

Examinatio
USG OBS
n
REPORT:-
Single intrauterine fetus having good cardiac activity & body movements was noted. Liquor
was adequate. Placenta was fundo anterior. Longitudinal Lie (Cephalic).
BPD 76mm
HC 274mm
FL 58mm
AC 215mm
EFW 1157 Grams
Normal 3-vessel umbilical cord with single loop encircling the neck. Normal cardiac 4
chamber view were seen. No obvious congenital anomaly seen. Color flow imaging showed a
vessel crossing the os. Internal os was not competent (width_05mm); however cervical
length measured about 38mm.
UMBILICAL ARTERY Doppler showed: PI_1.05, RI_0.68, S/D_3.08.
IMPRESSION:
CAN/Vasa Previa (Type I)
SUGGESTIONS:
Vasa previa is a term given when there are abnormal fetal vessels within the amniotic membranes that either
cross or run in extreme close proximity to the internal cervical os.
Vasa previa can be of two types:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

 Type I (present in ~ 90% of cases with vasa previa ) : abnormal fetal vessels connect a
velamentous cord insertion with the main body of the placenta OR
 Type II : abnormal vessels connect portions of a bilobed placenta, or a placenta with a
succenturiate lobe : due to this association, vasa previa needs to be excluded in patients with variant
placental morphology.
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To Self
Name Shumaila Age 35 Years Date 15-01-2018

Examinatio
USG OBS
n
REPORT:-
Placenta was fundo posterior. Longitudinal Lie (Cephalic)
BPD 8.05 cm
FL 5.97 cm
AC 27.11cm
GA 32+ Wks (Approx.) EDD 04.03.2019
Fetal Anotomy Details:
were normal. Transverse cerebellar diameter was 45mm. Abdominal wall was intact,
stomach showed normal situs. Kidneys and urinary bladder were normally visualized. No
skeletal dysplasia. Cervical canal measured 57mm and was competent.
Umbilical Artery showed:

RI_0.69, PI_1.06, S/D Ratio_3.20
Biophysical Profile:-
Placenta 02
Cardiac Activity 02
Breathing Movements 02
Amniotic Fluid 02
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

Tone 02
Gross Body Movements 02
Total 12/12
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR. Abdul Raheem Grewal
Name M. Mueen Age 25 Years Date 23-01-2019
DR # OPD/Indoor #
Examinatio
USG SCROTUM
n
Report:-
Gray Scale Imaging:
Left testes is normal in size, shape and outlines. No evidence of focal echogenic or echo
poor area is seen. Epdidymis and cord are swollen. Large amount of fluid is seen on left
side and it is tender to touch.
Right testes is normal in size, shape and outlines. No evidence of focal echogenic or echo
poor area is seen. Epdidymis and cord are normal. Small amount of fluid is seen on right
side and non tender to touch.
Arteries (Supra/Intra testicular) show normal flow pattern. Venous plexus showed no
dilatation. Both testes show normal flow.
IMPRESSION
Infected hydrocele
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

DR. Jamil U Rehman
NOT VALID FOR COURT
M.B.B.S, R.M.P

To DR.
Name Muqaddas Age 26 Years Date 23-01-2019
DR # OPD/Indoor #
REPORT:-
 Liver (span 16mm_Normal Range up to- 160mm ) showed homogeneous echo

texture with smooth surface. No focal lesion or dilated ducts seen. GB was normal.
CBD (03mm) & PV (1.4mm) showed normal calibers. Visualized Pancreas showed
normal reflectivity & contours. Spleen (9.6cm_Normal Range up to- 120mm) was normal.
hydronephrosis seen on either side. UB was empty.
IMPRESSION:
SUGGESTION:
DR. Jamil U Rehman

NOT VALID FOR COURT
M.B.B.S, R.M.P

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To DR.

Name Shamim Age 35 Years Date 06-11-2018

Examination USG ABDOMEN

DR. Jamil U Rehman

DHQ Hospital Pakpattan

 Liver (span 141mm_Normal Range up to- 160mm) showed homogeneous echo

DR. Jamil U Rehman

DHQ Hospital Pakpattan

DR. Jamil U Rehman

DHQ Hospital Pakpattan

DR. Jamil U Rehman

DHQ Hospital Pakpattan

Examination USG ABDOMEN

120mm) was normal.

DR. Jamil U Rehman

DHQ Hospital Pakpattan

Examination USG ABDOMEN

DR. Jamil U Rehman

DHQ Hospital Pakpattan

Examination USG ABDOMEN

DR. Jamil U Rehman

DHQ Hospital Pakpattan

Examination USG ABDOMEN

DR. Jamil U Rehman

DHQ Hospital Pakpattan

Examination USG ABDOMEN

DR. Jamil U Rehman

DHQ Hospital Pakpattan

 Hepatobiliary system, pancreas & spleen were unremarkable.

 Kidneys showed increased sinus and echo pattern with loss of

DR. Jamil U Rehman

DHQ Hospital Pakpattan

DR. Jamil U Rehman

DHQ Hospital Pakpattan

DR. Jamil U Rehman

DHQ Hospital Pakpattan

 Kidneys showed normal echo pattern with good corticomedullary

differentiation bilaterally. No evidence of calculus / hydronephrosis seen. UB was

partially filled. No Ascites.

DR. Jamil U Rehman

DHQ Hospital Pakpattan

 Rt. Kidney (102x44x16mm) showed mild HN. Lt. Kidney (96x38x18mm)

DR. Jamil U Rehman

DHQ Hospital Pakpattan

Examination USG ABDOMEN

DR. Jamil U Rehman

DHQ Hospital Pakpattan

DR. Jamil U Rehman

DHQ Hospital Pakpattan

Examination USG Pelvis

DR. Jamil U Rehman

DHQ Hospital Pakpattan

Complex adnexal mass may fall in one of the following entities:

DR. Jamil U Rehman

DHQ Hospital Pakpattan

DHQ Hospital Pakpattan

GA 12 Wks 02 Days (Approx.)

No uterine/adnexal mass seen.