Brief Answer:
Please find detailed answer below

Detailed Answer:
Hi XXXXX
Thanks for writing in to us.

I have read through your query in detail.
The ultrasound findings indicate that the liver is showing increased fat content and its size is also enlarged. The spleen (an organ in left side of abdomen) is also enlarged in size.

There are many causes for an enlarged fatty liver and spleen which includes infections, disorders of the liver and causes in the spleen. Fatty liver itself may cause hepatosplenomegaly.

If you have clinical symptoms which cannot be entirely explained by fatty hepatosplenomegaly then a higher imaging by CT scan may be considered depending on your other test results. This is because sometimes it gets difficult to visualize the liver in detail buy ultrasound due to certain limitations. This does not mean your liver is under assessed but that if there is any element of doubt, it can be removed by superior imaging methods.

Wishing you good health.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Undifferentiated connective tissue disorders

Detailed Answer:
Hi,

Thanks for writing in with an update.

At first I suppose your liver was not visualized in detail on ultrasound as you have mentioned over weight and this means the sound beams cannot adequately image the liver and therefore your doctor has mentioned accordingly.

Discussing your other point on connective tissue disorders, there are many symptoms which do not exactly fit into one particular disease condition and this is called as undifferentiated connective tissue disorder. To come to a possible diagnosis it requires extensive lab work and detailed clinical tests.

Routine screening tests for undifferentiated connective-tissue disease (UCTD) should include the following:
Complete blood count
Erythrocyte sedimentation rate (ESR)
C-reactive protein (CRP)
Urinalysis with microscopic analysis
Serum creatinine
Rheumatoid factor (RF)
Antinuclear antibodies (ANA): using an immunofluorescence assay (IFA)
Further testing is done depending on the results of above mentioned tests.

Hope your query is answered.
Do write back if you have any further doubts.

Regards,
Dr.Vivek

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Brief Answer:
Further evaluation only if necessary

Detailed Answer:
Hi XXXX
Thanks for writing in with an update.

What I meant to say is that connective tissue disorders present with many symptoms and sometimes the symptoms are not clear enough to categorize it as lupus, rheumatoid etc but may show a mixed picture. If your rheumatoid doctor has made note of your symptoms 15 years back and you do not have any significant symptoms pointing to connective tissue disorders then its most likely that you do not have it. Therefore please do not worry about it.

Coming to the liver problem, I have come across patients who are over weight and in them some of the areas in the liver may not be clearly visualized due to increase in body fat content. Your doctor has done his best in examining your liver but some areas were not well visualized as you are over weight. Under such circumstances, if your liver tests are normal or slightly above normal then nothing needs to be done. If liver tests are unusually abnormal and if you have pain in the region or have a lumpy feeling then you must get a higher investigation to evaluate your liver, like CT scan or MRI scan done as felt necessary by your doctor.

Hope your query is answered.
Do write back if you have any further doubts.

Regards,
Dr.Vivek

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