Case 2: A 33-year-old male with a right UVJ stone.\nRadiologist description: focal thickening of the right posterior bladder wall, with slight inward protrusion of this portion of the wall. There is also the suggestion of a small cystic focus at the level of the right UVJ, which may represent dilation of the intramural portion of the distal ureter.
Case 7: A 44-year-old man with a left proximal ureteric stone\nRadiologist description: minimal asymmetry along the posterior bladder wall, with flattening of the left side.\nRadiologist description: slight inward protrusion of the left posterior bladder wall.\nAll 7 patients in the case series had confirmed ureterolithiasis and an EDUS that showed a unilateral inward bulge of their bladder on the symptomatic side. Stone size and location varied (). In cases 5 and 7, there was the suggestion of a correlating bulge seen on CT (, ), although this finding was subtler. The bladder bulge sign is therefore felt to be primarily, if not exclusively, a sonographic finding. Case 4 had the CT performed 12 days prior to the EDUS making it likely that her stone had migrated to the UVJ by the time of her EDUS. Four of our patients had no hydronephrosis. One patient had neither hydronephrosis nor hematuria.