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Urine Sediment of the Month: RBC “Lookalikes”
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Urine Sediment of the Month: RBC “Lookalikes”
Red blood cells (RBCs) in the urine are normally 7-8 µm in diameter, circular or slightly oval and biconcave in appearance. They may appear crenated, with symmetric spiked membrane contour in hypertonic urine, or spherical, with near loss…
Leukocyte Lysis in Dilute Urine
The influence of urine concentration on the cells we observe during urine microscopy is well known. Concentrated urine specimens with a high urine specific gravity (SG) preserve nucleated cellular morphology the best, however, some cellular structures (e.g.: erythrocytes)…
Urine Sediment of the Month: The Thin Waxy Cast
The thickness of the fluid layer examined by urinary microscopy is determined by the volume of resuspended sediment put on the glass slide and the size of the coverslip. Using 13-15ul of sediment and coverslips of 18x18mm2 as…
The Case of the Missing Casts
A 50 y/o woman presents with symptoms of fatigue and malaise for 1-2 weeks. Medications include ACE, HCTZ, and a multivitamin daily. She had a UTI 6 weeks ago that did not improve after a 5 day course…
Urine Sediment of the Month: Oblique Illumination in Microscopy
Urinary sediment microscopy is a diagnostic technique designed to acquire 2-dimensional images of structures present in a slide. However, 2-dimensional views may lack sufficient contrast to allow for optimal visualization. One way to enhance the images and create…
Urine Sediment of the Month: Identifying Phagocytosed Particles
“What am I looking at? ” Phagocytosis and particle internalization by cells in the urine is not common, but of clinical interest when it occurs.Phagocytosis/particle internalization can be observed in urine microscopy by the usual culprits: professional phagocytes…
Urine Sediment of the Month: Beyond the Urizon
One of the welcome side-effects of doing your own urine sediment examination is having easy access to a microscope and some basic lab equipment. This allows you to examine all sorts of things besides urine (Fig. 1). For…
Urine Sediment of the Month: To Stain or Not to Stain
To stain, or not to stain, that is the question. Different illumination techniques are available to visualize the formed elements in the urinary sediment. The two most commonly used are brightfield and phase contrast. Brightfield illumination provides high…
Urine Sediment of the Month: Pathologic Crystals in the Urine
Urinary crystals are a frequent finding and there are several different types that can be observed under the microscope. We’ve discussed some of these crystals in a previous Urine Sediment of the Month post. Unlike these more common…
Urine Sediment of the Month: Crystal Casts
Identification of crystals and casts by microscopic examination of the urinary sediment is of clinical importance. Specifics about crystals and casts have been previously covered in preceding posts of this blog. Interestingly, crystalline structures can occasionally be embedded…