Pitfalls The rib shadows often obstruct visualization of the kidney; slight probe rotation can mitigate this effect The left kidney often requires a more posterior and superior approach than expected If localization remains difficult, having the patient breathe deeply often causes inspiration to push the kidney into view FIGURE 131.18 A, B, C: Longitudinal section of the left kidney reveals nephrolithiasis (arrows ) in the superior and inferior poles in the same patient (Images courtesy of Christi Tumblin, Zanesville, OH In: Kawamura D, Lunsford B, eds Diagnostic Medical Sonography 3rd ed Philadelphia, PA: Lippincott Williams & Wilkins; 2012 With permission.)