NBME Step 2 CK Form 8 Retrograde urethrography (NBME Answers)

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Young man with significant trauma found to have signs of pelvic fracture (pelvic pain with crepitus/tenderness over the pubis, x-ray findings) found to have a large scrotal hematoma, concerning for a urethral injury
Key idea: Although classically a pelvic fracture would injure the membranous portion of the urethra (leading to a high-riding prostate and blood at the urethral meatus), it can also damage the bulbar (spongy) urethra and lead to blood accumulation in the scrotum and blood at urethral meatus
Key idea: Retrograde urethrogram is the first test to perform in patients with suspected urethral injury

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frijoles Also bulbar urethral injuries are more common in straddle injuries. Although he has a pelvic fracture, a straddle injury could have also occurred during his motor cycle accident. +