Micturating cystourethrogram shows filling defect in the urinary bladder. Likely diagnosis is________
**Core Concept**
A micturating cystourethrogram (MCUG) is a radiographic study that visualizes the urinary bladder and urethra during urination. It is commonly used to diagnose anatomical abnormalities, such as bladder tumors, stones, or foreign bodies, that can cause a filling defect in the urinary bladder.
**Why the Correct Answer is Right**
A filling defect in the urinary bladder on MCUG is likely due to a bladder stone or tumor. Bladder stones are typically composed of calcium oxalate or struvite and can cause a rounded filling defect within the bladder lumen. Tumors, such as transitional cell carcinoma, can also present as a filling defect or mass within the bladder wall. The presence of a filling defect on MCUG warrants further investigation, including imaging with ultrasound or CT scan, and possible biopsy to confirm the diagnosis.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not provided.
**Option B:** A bladder diverticulum would not typically present as a filling defect on MCUG, but rather as a diverticulum or outpouching of the bladder wall.
**Option C:** Vesicoureteral reflux (VUR) is a condition where urine flows retrogradely from the bladder into the ureter, but it would not cause a filling defect on MCUG.
**Option D:** This option is not provided.
**Clinical Pearl / High-Yield Fact**
A filling defect on MCUG can also be caused by a foreign body, such as a Foley catheter, urinary stone, or a piece of cloth. It is essential to consider these possibilities when interpreting MCUG results.
**Correct Answer:** B. Bladder diverticulum.