Renal Ultrasonography

Renal Ultrasonography: What It Is and Why Doctors Use It

Renal ultrasonography is an imaging examination that uses high-frequency sound waves to build real-time pictures of the kidneys, the collecting systems that drain urine towards the bladder, and usually the bladder itself. It involves no ionising radiation, no needles and no anaesthesia, and in most cases it is completed within a single short appointment. Doctors use it as an early diagnostic step for people with flank pain, blood in the urine, recurrent urinary infections, abnormal kidney blood tests, or a known kidney cyst or mass — and as a safe, repeatable way to monitor conditions that have already been diagnosed.

When your physician recommends a kidney ultrasound, there is usually a specific question behind the request. Are the kidneys a normal size and shape? Is urine draining freely, or is something blocking its path? Could your pain be caused by a stone? Is a cyst found on a previous scan harmless, or does it have features that deserve a closer look? For many patients, that uncertainty is more stressful than the examination itself, which is brief, quiet and generally undemanding.

The value of the test lies not only in the images but in how those images are obtained, interpreted and connected to the rest of your medical picture. A kidney ultrasound performed within a coordinated renal radiology service can help determine whether you need reassurance, a period of monitoring, medication, further imaging, or assessment by a urology or nephrology team. At Acibadem, the examination sits inside that wider diagnostic pathway rather than standing alone, so a finding leads to a plan rather than to more uncertainty.

What is renal ultrasonography?

Renal ultrasonography — also called a kidney ultrasound or renal ultrasound — is a scan in which a handheld device called a transducer is placed on the skin with a layer of clear gel. The transducer sends sound waves into the body and receives the echoes as they bounce back from different tissues. A computer converts those echoes into moving images that appear immediately on a monitor. Because the images are live, the person scanning can angle the probe, ask you to shift position or hold your breath for a moment, and concentrate on exactly the area that matters for your symptoms.

A standard examination assesses kidney size, shape, position and internal structure, including the thickness and appearance of the outer kidney tissue. It can detect many kidney cysts, some tumours, swelling of the kidney caused by blocked urine flow, structural signs associated with chronic kidney disease, and many stones — particularly stones sitting within the kidney or causing obstruction. When the bladder is included, the scan can assess the bladder wall, measure urine volume before and after urination, and show whether the bladder empties adequately. In adults, the kidneys are measured against expected size ranges, and the two sides are compared with each other, because asymmetry itself can be an important clue.

A kidney ultrasound is often the first imaging test, not necessarily the final one. If the scan shows an unclear lesion, a complex cyst, a possible tumour, or findings that need finer detail, your physician may recommend CT, MRI, contrast-enhanced ultrasound where appropriate, laboratory testing, urine studies, cystoscopy, or a renal biopsy in selected cases. The scan is best understood as a highly useful tool within an evidence-based evaluation plan, not as a verdict in itself.

Why would a doctor order a renal ultrasound?

A doctor orders a renal ultrasound when they need a safe, quick look at the structure of the kidneys and urinary tract — most often to investigate pain, blood in the urine, infection, abnormal kidney blood tests, or a finding picked up on another scan. Common reasons include:

• Pain in the side or back, especially pain that travels towards the groin
• Visible or microscopic blood in the urine (haematuria)
• Recurrent urinary tract infections, or fever combined with urinary symptoms
• Raised creatinine or reduced estimated glomerular filtration rate on blood tests
• Checking a known cyst, stone or mass, or a finding from a previous scan
• Assessing whether urine flow is blocked and the kidney is swollen
• Measuring how well the bladder empties, for example when the prostate is enlarged
• Monitoring a transplanted kidney or a chronic kidney condition over time

Who May Need a Kidney Ultrasound?

Patients are referred for a kidney ultrasound for many different reasons. Some have symptoms that point towards a kidney or urinary tract problem. Others have abnormal laboratory results, a finding discovered incidentally during another examination, or a known condition that needs surveillance. A kidney ultrasound may also form part of a comprehensive check-up when kidney function, urinary symptoms or previous imaging results require expert review and comparison.

Symptoms that commonly lead to the examination include pain in the side or back, pain radiating towards the groin, visible or microscopic blood in the urine, painful urination, unusually frequent urination, recurrent urinary tract infections, fever accompanied by urinary symptoms, difficulty passing urine, or a noticeable reduction in urine output. In men, the scan may be requested when bladder emptying is affected by prostate enlargement, because the ultrasound can measure how much urine remains after voiding. In children, it is used to investigate urinary infections, congenital abnormalities of the kidneys and urinary tract, bedwetting when it occurs alongside other symptoms, or findings noted on prenatal scans that need follow-up after birth.

The test is also frequently recommended when blood tests show changes in kidney function, such as elevated creatinine or a reduced estimated glomerular filtration rate. Ultrasound can help determine whether the kidneys appear small and scarred, swollen from obstruction, affected by cystic disease, or otherwise structurally abnormal — distinctions that matter because they point towards very different causes and very different treatments. It may likewise be used when urine tests show protein, blood, markers of infection, or other findings that need an anatomical explanation.

Diagnosis rarely begins with the scan itself. It usually starts with a medical history and physical examination. Your physician may ask about the location and pattern of any pain, fever, previous stones, past urinary infections, current medications, hydration habits, family history of kidney disease, cancer history, pregnancy, prostate symptoms, blood pressure and any earlier imaging. Laboratory work may include kidney function tests, electrolytes, urinalysis, urine culture, or tumour-related investigations when clinically indicated. The ultrasound then supplies the anatomical information that places those clinical and laboratory findings into context.

Typical situations in which the examination is appropriate include: a new episode of kidney-stone-like pain; repeated urinary infections; suspected obstruction of urine flow; monitoring of a simple kidney cyst; evaluation of a mass first seen on another scan; investigation of chronic kidney disease; assessment of kidney size before or after treatment; review of congenital urinary tract conditions; checking for hydronephrosis during pregnancy; and follow-up after a kidney transplant. Ultrasound is also used to guide certain procedures, such as drainage or biopsy, although procedural ultrasound is a separate, carefully planned process with its own preparation and consent.

Conditions a Kidney Ultrasound Can Help Evaluate

A kidney ultrasound covers a wide range of kidney and urinary tract concerns. The most common are outlined below, together with an honest account of where the scan performs well and where it reaches its limits.

Hydronephrosis and urinary obstruction

Hydronephrosis is swelling of the kidney’s collecting system that occurs when urine cannot drain normally from the kidney to the bladder. Ultrasound is well suited to identifying this swelling and to grading it as mild, moderate or severe — a grading that helps decide how urgently the cause needs to be found. The underlying cause may be a stone, a narrowing in the drainage system, a tumour, an enlarged prostate, pregnancy-related compression, scar tissue from previous surgery or infection, or a congenital abnormality present from birth. The scan often shows the swelling clearly even when the cause itself needs a different test to pin down.

Kidney stones

Ultrasound can identify many stones sitting within the kidney and can show indirect evidence of a stone blocking urine flow, such as hydronephrosis on the affected side. It has honest limits here: very small stones, stones lodged in certain parts of the ureter, and stones in patients with challenging anatomy may not be visible. When symptoms and risk factors continue to suggest a stone despite a normal ultrasound, CT or other imaging may be recommended. For people with repeated stones, the scan also plays a longer-term role, tracking known stones over time and checking for new ones without any radiation exposure.

Kidney cysts

Kidney cysts are among the most common findings on renal ultrasound, and they become more frequent with age. Many are simple cysts: thin-walled, fluid-filled sacs that are usually benign and need little or no treatment unless they cause symptoms or grow very large. Ultrasound is good at separating these from cysts with more complex features — internal walls or septations, thickened rims, calcifications or solid components. Complex cysts are not automatically dangerous, but they do warrant additional imaging and specialist assessment, because their appearance overlaps with lesions that need active management.

Solid kidney masses

Ultrasound can detect solid masses and areas of the kidney that look different from normal tissue. What it cannot always do is say precisely what a mass is. Its main contribution is to establish whether a finding is cystic or solid and whether further evaluation is needed. When a possible tumour is seen, physicians typically recommend contrast-enhanced CT or MRI and a urology consultation; in selected cases the findings are reviewed by a multidisciplinary tumour board, where imaging, laboratory results and clinical factors are weighed together before any decision about treatment is made.

Chronic kidney disease

In chronic kidney disease, ultrasound shows whether the kidneys are normal-sized, enlarged, scarred, thinned or affected by cystic change. These features help physicians judge whether damage is longstanding and whether obstruction, congenital conditions, vascular causes or systemic disease may be contributing. In some patients, the ultrasound appearance influences whether a kidney biopsy would add useful information or whether management should concentrate on medical treatment and monitoring. Where kidney function has declined substantially, structural findings also feed into longer-term planning conversations, which may involve the renal replacement team and, alongside medical care, structured dietary support through renal nutrition services.

Other indications

Further indications include recurrent urinary tract infections, congenital kidney and urinary tract abnormalities, damage related to urinary reflux, polycystic kidney disease, renal trauma in selected contexts, urinary retention in the bladder, abnormal bladder wall findings, and concerns about the renal arteries or veins when Doppler imaging is added. Ultrasound is also routinely used after urinary tract surgery or procedures to confirm that drainage has been restored. In transplant patients, it is one of the central monitoring tools, assessing the size of the transplanted kidney, its blood supply, any fluid collections around it, obstruction and other post-transplant issues — all without radiation, which matters for a group of patients scanned repeatedly over many years.

How the Examination Is Performed

The examination is straightforward, but careful technique matters. Before the scan, the care team reviews the reason for imaging, your relevant symptoms, previous test results and any earlier scans. If you have been evaluated elsewhere, bringing earlier ultrasound, CT or MRI reports — and ideally the digital image files themselves — is genuinely useful. Comparing current and previous images lets the radiologist say whether a cyst, stone, mass or area of swelling is new, stable or changing, which is often the single most important question.

A typical appointment follows this sequence:

1. You check in, and the team confirms the reason for the scan and any preparation you were asked to follow.
2. You lie on an examination table, usually on your back to begin with.
3. Warm or room-temperature gel is applied to the skin over your abdomen and sides; the gel helps the sound waves travel between the probe and your body.
4. The sonographer or radiology physician moves the transducer across the skin to view each kidney from several angles. The right kidney is often imaged through the liver, which provides a clear acoustic window; the left kidney is usually approached from the side or back.
5. You may be asked to turn onto one side, take a deep breath and hold it briefly, or shift position so a kidney can be seen more completely.
6. Measurements are taken, the internal structure of each kidney is assessed, and the collecting systems are checked for swelling.
7. If the bladder is included, it is imaged while full; if a post-void residual measurement is requested, you will be asked to urinate and then be scanned again to measure how much urine remains.
8. If Doppler views are needed, additional images of blood flow are recorded. The gel is then wiped away and the examination is complete.

Throughout the scan, the team is looking systematically for stones, cysts, masses, swelling of the collecting system, scarring, asymmetry between the two kidneys, fluid around the kidney and any other abnormality. The examination almost always includes both kidneys, even when symptoms affect only one side, because the comparison between them is diagnostically valuable.

Do I have to undress for a renal ultrasound?

Usually only partially. You need to expose the skin over your abdomen and flanks, so you may be asked to lift or remove your top, lower a waistband slightly, or change into a gown, depending on the department’s routine. Wearing loose, two-piece clothing makes this easier. You do not normally need to remove anything else, and there is no restriction on jewellery for a standard kidney scan. Privacy is maintained in the usual way, with only the area being scanned uncovered at any time.

Is a renal ultrasound painful?

For most people, no — the probe presses gently on the skin and the main sensations are the coolness of the gel and mild pressure. There are two honest exceptions. If your flank is already tender, for example from a suspected stone, pressing on that area can cause temporary discomfort; tell the sonographer, and the pressure can be reduced. And if you were asked to arrive with a full bladder, the fullness itself can be uncomfortable until you are allowed to urinate. Neither involves needles, injections or anaesthesia.

How long does a kidney ultrasound take?

A routine renal ultrasound often takes about 20 to 45 minutes. The exact length depends on whether the bladder is included, whether a post-void measurement is needed, whether Doppler blood flow imaging is added, and whether a transplanted kidney or additional areas are being assessed. Difficult imaging conditions — bowel gas, previous surgery, limited ability to change position — can also extend the appointment somewhat.

What is a renal Doppler ultrasound?

A renal Doppler ultrasound is an extension of the standard scan that evaluates the direction and speed of blood flow in the renal arteries and veins. Physicians request it when assessing certain causes of high blood pressure, suspected narrowing of a kidney artery, the blood supply of a transplanted kidney, possible blood clots, or vascular abnormalities and complications after procedures. Doppler imaging is more operator-dependent than standard views and may take longer, especially when bowel gas, body build, prior surgery or unusual anatomy makes the vessels harder to see. When a significant arterial narrowing is suspected, the findings may lead on to dedicated vascular imaging or a renal angio study for confirmation and, where appropriate, treatment planning.

The technology behind the examination includes high-resolution ultrasound systems, different transducer types suited to superficial and deeper structures, Doppler software for blood flow analysis, and digital image archiving that allows studies to be compared over months and years. For you as the patient, the practical benefits are simple: real-time imaging that can be adjusted on the spot, no radiation exposure, rapid assessment, and the ability to focus the scan directly on the area of concern.

Once the images are obtained, a radiology physician reviews them and prepares a written report describing the findings, often with recommendations for follow-up or additional testing. Your referring physician then interprets that report alongside your symptoms, laboratory values and medical history. In a coordinated hospital setting, significant findings can be discussed directly with the relevant specialist so that the next step is not delayed by paperwork.

How to Prepare for a Kidney Ultrasound

Preparation depends on the type of examination requested. For a routine kidney ultrasound that includes the bladder, you may be asked to drink water before the appointment and to avoid emptying your bladder, so that the bladder can be properly assessed. A comfortably full bladder shows its shape, wall thickness and urine volume far better than an empty one. If a post-void residual measurement has been requested, the sequence is deliberate: the full bladder is imaged first, you then urinate, and the bladder is imaged again to measure what remains.

For Doppler evaluation of the kidney blood vessels, fasting for several hours is sometimes requested. This reduces bowel gas, which otherwise sits in front of the deep abdominal vessels and degrades the images. Your appointment instructions will state whether fasting applies to you; for a standard kidney scan it usually does not.

Which statement is true about patient preparation for renal ultrasonography?

The accurate statement is that a standard renal ultrasound requires very little preparation: no sedation, no contrast injection and, in most cases, no fasting. The most common instruction is the opposite of restriction — drink water beforehand and arrive with a comfortably full bladder if bladder assessment is planned. Fasting is requested only for specific studies, most often Doppler examinations of the renal vessels. The scan itself does not require any change to your medicines; questions about medication always belong with your treating doctor, not with the scan appointment. If you are given written preparation instructions, they take precedence over general guidance, because they reflect the specific study your physician has ordered.

What not to do before a renal ultrasound?

The short answer: do not empty your bladder shortly before the appointment if bladder assessment is planned, and do not arrive dehydrated. Beyond that, a few practical points help the examination succeed:

• If your instructions include fasting for a Doppler study, avoid eating within the stated window — a gas-filled bowel can hide the vessels the scan is meant to show.
• Do not leave previous imaging reports or discs at home; comparison with earlier studies is one of the most valuable parts of the interpretation.
• Avoid tight, one-piece clothing that makes it awkward to expose the abdomen and flanks.
• Do not assume the scan is cancelled if you could not follow the preparation exactly — attend anyway and tell the team, as the examination can often still be performed or adapted.

Why Acting Early Matters

Kidney and urinary tract conditions can progress quietly. A patient may have only mild discomfort, intermittent symptoms, or abnormal blood and urine tests without significant pain. A kidney ultrasound can identify problems before they cause more serious complications, particularly where obstruction, infection, declining kidney function or a suspicious lesion is involved.

Obstruction is the clearest example. If urine flow is blocked, pressure builds within the kidney. Short-term obstruction may be reversible, but prolonged or severe obstruction can damage kidney tissue. When obstruction is combined with infection, the situation can become urgent and may require rapid drainage and antibiotics. Ultrasound detects the hydronephrosis that obstruction produces and helps establish how quickly a urologic evaluation is needed.

Early imaging also matters when blood appears in the urine. Haematuria can be caused by stones, infection, inflammation, an enlarged prostate, kidney disease or tumours. Not every cause is dangerous, but persistent or unexplained blood in the urine deserves a proper evaluation. Ultrasound is often part of that work-up, sometimes alongside urine tests, cystoscopy or cross-sectional imaging, depending on age, risk factors and clinical findings.

For cysts and masses, early characterisation prevents two opposite problems: unnecessary anxiety when a finding is clearly benign, and delayed work-up when a lesion has features that need attention. A simple cyst may need nothing more than documentation or occasional monitoring; a complex cyst or solid mass needs advanced imaging and specialist review, and the sooner that distinction is made, the better the decisions that follow.

In chronic kidney disease, an early ultrasound can identify reversible contributors such as obstruction or treatable structural problems, and can indicate whether kidney changes are longstanding. That information supports decisions about blood pressure control, diabetes management, avoidance of kidney-toxic drugs, monitoring frequency and referral to a nephrologist. In patients whose heart and kidney problems interact — the pattern described as cardiorenal syndrome — structural imaging of the kidneys is one piece of a broader assessment that shapes treatment on both fronts.

Delaying evaluation carries real costs: persistent pain, recurrent infections, worsening kidney function, emergency hospital visits, and missed opportunities for less invasive management. Ultrasound is not the answer to every kidney question, but it is very often the safest and most efficient way to begin the right diagnostic pathway.

Benefits of a Kidney Ultrasound

The benefits of the examination are both medical and practical, particularly when the images are interpreted in the context of your full clinical picture rather than in isolation.

Benefit	What It Means for You
No ionising radiation	Ultrasound uses sound waves rather than X-rays, making it suitable as initial or repeated imaging for many patients, including children and pregnant patients when clinically appropriate.
Non-invasive and usually comfortable	The scan is performed on the skin with gel and a handheld transducer. It typically requires no needles, no anaesthesia and no recovery time.
Broad diagnostic reach	It can help evaluate hydronephrosis, many stones, cysts, kidney size, bladder emptying, some masses and selected blood flow concerns when Doppler is added.
Real-time imaging	The radiology team can adjust the examination as it happens, change your position and concentrate on the area of symptoms or abnormal findings.
Supports timely decisions	Results help determine whether you need reassurance, monitoring, medication, specialist care, urgent treatment or further imaging.
Safe for follow-up	Because it is repeatable without radiation, ultrasound is well suited to monitoring known cysts, obstruction, chronic kidney conditions or post-treatment findings over time.

What Happens After the Scan

Because the examination is non-invasive, there is no recovery in the usual sense — you can generally return to normal activities immediately, unless your physician has given other instructions because of your underlying condition. What follows the scan depends entirely on what it shows and why it was requested.

Time Period	What Patients Can Expect
Day 1	Normal activities resume straight away. If you attended with a full bladder, any temporary discomfort settles once you urinate after the examination.
First week	Your physician reviews the radiology report alongside your symptoms and laboratory results. Normal findings may mean no further imaging is needed; abnormal findings lead to a planned next step.
First month	Depending on the diagnosis, treatment may begin — for infection, stones, obstruction, kidney function concerns or other conditions — and some patients are referred to urology or nephrology.
Longer term	Follow-up ultrasound may be recommended for certain cysts, chronic kidney disease, transplant monitoring, recurrent stones, or checking drainage after obstruction has been treated.

What a Kidney Ultrasound Can and Cannot Tell You

The value of a renal ultrasound result depends on several factors, and it is worth being clear about them. The first is the clinical question itself. Ultrasound is highly useful for many structural concerns, but it has genuine limits: small ureteral stones, early tumours, subtle inflammation and certain vascular problems can be difficult or impossible to see. When clinical concern remains high despite a normal ultrasound, further tests may still be necessary — a normal scan narrows the possibilities, it does not always close the question.

Patient anatomy influences image quality. Bowel gas, body build, previous surgery, severe pain that limits position changes, difficulty holding the breath, or a bladder that is not adequately filled can all make structures harder to see. Skilled sonographers and radiologists work around these challenges — changing positions, using different imaging windows, adjusting machine settings — but some limitations are simply physical and cannot be scanned away.

Preparation matters too. Arriving with a comfortably full bladder makes bladder assessment more informative; following fasting instructions improves Doppler visualisation. Equally important is what you tell the team: pregnancy, a kidney transplant, previous kidney surgery, known stones, cancer history, current urinary symptoms and recent laboratory results all shape how the examination is performed and how the findings are read.

The experience of the imaging team is a real variable. Renal ultrasound is operator-dependent — the quality of the study reflects how the images are acquired as well as how they are interpreted. A careful examination includes appropriate measurements, multiple views, assessment of both kidneys, evaluation of the collecting systems and bladder assessment when indicated. In complex cases, radiology physicians correlate the ultrasound findings with CT, MRI, blood tests and specialist input rather than reporting the scan in a vacuum.

Finally, a technically excellent scan is only useful if the result leads to the right next step. A simple cyst may need no treatment at all. Hydronephrosis may need urgent or planned urologic evaluation. A suspected mass needs advanced imaging. Chronic structural change points towards nephrology care. Recurrent stones prompt metabolic evaluation and a prevention plan. The best outcome of a renal ultrasound is not merely an image — it is a clear diagnosis, an appropriate level of concern and a plan proportionate to both.

Continuity of information deserves special emphasis. Bringing prior reports, digital image files, medication lists and laboratory results avoids repeated testing and allows accurate comparison over time. If you have had imaging at another hospital, the original digital images are usually more valuable than the written report alone: they let the radiologist judge directly whether a finding has changed and whether follow-up recommendations should be adjusted.

Kidney Ultrasound at Acibadem

A diagnostic scan is only as useful as the pathway around it. At Acibadem, kidney ultrasound is performed within a hospital-based diagnostic environment where radiology, urology, nephrology, oncology and other specialties collaborate when a finding requires it. The practical machinery of a hospital — imaging protocols, structured reporting, documentation and coordination between departments — matters as much for a diagnostic examination as it does for surgery, because it determines whether a result reaches the right specialist and leads to a decision.

The radiology pathway is built to support accurate diagnosis. Modern ultrasound systems provide high-resolution imaging of the kidneys and urinary tract, Doppler capability allows selected blood flow assessment, and digital image storage enables comparison with earlier and later studies. When ultrasound findings are inconclusive or point towards a condition that needs clarification, physicians recommend CT, MRI, laboratory testing, endoscopic evaluation or specialist consultation according to evidence-based protocols — additional testing when it adds information, not by default.

Renal ultrasound frequently opens the door to multidisciplinary care. A patient with recurrent stones may need urology evaluation, metabolic testing and prevention advice. A patient with reduced kidney function may need nephrology assessment and a medication review by the treating team. A patient with a suspicious renal mass may benefit from urologic oncology input and discussion in a multidisciplinary tumour board, where imaging, laboratory findings and clinical factors are reviewed together. A transplant patient may need coordinated input from transplant physicians, nephrologists and radiologists. The point of this integration is simple: the ultrasound result is never viewed in isolation.

Personalised interpretation matters in kidney and urinary tract conditions because the same imaging finding can mean different things for different patients. A small stone may be monitored in one patient and treated in another, depending on symptoms, infection risk and kidney function. A cyst may need no action if its features are simple, and further imaging if they are complex. Mild hydronephrosis may be observed in one situation and treated urgently in another, when infection or declining kidney function is present. Careful, individual interpretation protects patients from both overtreatment and under-treatment.

Many patients also seek a second opinion. In that setting, a kidney ultrasound may be performed to confirm a previous finding, clarify a diagnosis, or inform a decision about stone treatment, surgery, cancer evaluation or kidney disease management. Physicians review prior images and reports, recommend additional imaging only where it genuinely adds value, and explain the reasoning behind the proposed plan. For an anxious patient, that clarity of reasoning is often as important as the result itself.

Communication shapes the whole experience. Imaging reports contain technical language, and kidney findings can sound alarming without context. A well-coordinated team translates the report into practical meaning: what was found, what was not found, how confident the finding is, whether it is urgent, and what should happen next. For patients continuing their care with a referring physician, clear documentation and written follow-up recommendations make that transition safe and orderly.

Moving Forward with Clarity

A kidney ultrasound is a safe, non-invasive and widely used examination that answers important structural questions about the kidneys, urinary tract and bladder. It can identify obstruction, many stones, cysts, changes in kidney size, bladder-emptying problems and selected blood flow concerns, and it helps determine whether further imaging or specialist care is needed — all without radiation and usually within a single appointment.

For people with flank pain, recurrent urinary infections, blood in the urine, abnormal kidney function tests, a known cyst, a possible mass, or a previous imaging result that needs expert comparison, a kidney ultrasound is often an appropriate early step in the diagnostic process. The most useful evaluation begins with your symptoms and history, continues with careful, well-prepared imaging, and ends with a plan that matches the diagnosis and your personal circumstances — whether that plan is reassurance, monitoring, treatment or further investigation.