Ultrasound of gallbladder sludge

Ultrasound of the gallbladder in sagittal (A) and transverse (B) projections in an 80-year-old male with right upper quadrant pain reveals a normal sized gallbladder with layering sludge (arrow). Some brighter non shadowing foci are appreciated in the sludge (arrowhead). One month after the ultrasound, the patient had a cholecystectomy. Noted within the sludge were small stones, the largest of which was 0.5 mm. The gallbladder was not inflamed at that time.