In this video lecture, we discuss the imaging appearance of adrenal hemorrhage on CT, MRI and ultrasound. Causes of adrenal hemorrhage will also be reviewed. 

Key points include:

• On CT scan, adrenal hemorrhage typically appears as a nonenhancing round or oval hyperdense mass with density of 50-90 HU. 
• MRI is the most sensitive and specific modality for diagnosing adrenal hemorrhage. 
• The “high signal intensity rim” rim sign seen on T1-weighted images is characteristic of subacute adrenal hemorrhage. 
• Adrenal hemorrhage may appear solid or cystic on ultrasound depending on the age of hemorrhage.
• Adrenal hemorrhage is more common in neonates than in children and adults and is the most common adrenal mass in infancy.
• Trauma is the most common cause and is usually unilateral and right-sided. 
• Atraumatic adrenal hemorrhage is usually unilateral.

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