Need Help Understanding Ultrasound Results

[rocket777]

Hi there!

This is my first time posting and thank you in advance to anyone who takes the time the read this.

Background: I'm a 27 yr old female, not overweight but at the high end of the "healthy range" (145/6 lbs at 5'6"), and I have a connective tissue disorder called Ehlers-Danlos Syndrome. I've experienced pain on my ride side under the ribs for about 6 months now. For most of that time it only hurt if I twisted wrong, but now the pain is constant and includes pain in my right shoulder blade. At first I thought it was just a rib out of alignment (I have that issue a lot), but my doc wanted to make sure it wasn't something like kidney stones or gallstones so he had me do an abdominal ultrasound.

The ultrasound came back showing a kidney stone but it was on the left side, so shouldn't be causing the right-sided pain. And the following about my liver:

"Liver: The liver measures 14.8cm. Subtle relative increased echogenicity to the margins of the portal venules is noted which may be due to the patient being very thin with good acoustic transmission. A centrilobular or starry sky pattern accounting for this appearance cannot entirely be excluded. Clinical and laboratory correlation would be recommended to rule out diffuse hepatic process. The liver otherwise appears normal without discrete lesions seen."

My doc said that it means my liver is inflamed, but has never seen a report include something like that before. He had me get a chest x-ray (came back normal) and an echocardiogram to check for valve regurgitation which I guess can be common in people with connective tissue disorders and can cause issues with the liver. That report came back as normal but with trivial regurgitation for the Mitral, Tricuspid, and Pulmonic valves. My doc is referring me to a specialist, but I have to wait a bit while I deal with an insurance switch.

Has anyone seen anything like this before? Could the inflammation of the liver be causing my pain (it seems to be getting worse) or is it more likely something with my ribs? Can "trivial regurgitation" of heart valves cause liver problems over time? The valve issue makes the most sense to me since I've not experiencing any other symptoms like jaundice. The echocardiogram result also listed the "Study Quality" as "Fair". Is it possible there is more significant regurgitation that was missed due to the quality of the test?

Thanks again for reading and I appreciate any responses!

[rocket777]

Thank you for your response. I will definitely see a specialist to follow up on this and investigate what could be causing it. Thanks again!

[Dr Santos]

Hi,
I understand your concern regarding your symptoms. It is good that the x-ray and echocardiogram were okay. With Ehlers-Danlos Syndrome gastrointestinal issues may be present  also such as  abdominal pain, bleeding or perforation. gastric diverticula,
peptic ulcer, diaphragmatic eventration, hiatal hernia, kyphoscoliosis, and intraabdominal adhesions. If ultrasound shows liver inflammation, further evaluation may need to be done. You may benefit from a specialist's evaluation also Take care and do keep us posted.