As for why cholecystitis appears normal in an ultrasound, there are two possible reasons. One possibility is that the medical practitioner conducting the ultrasound may lack sufficient clinical experience to identify an inflamed gallbladder. Another reason could be limitations in the ultrasound equipment itself, which might fail to detect an inflamed gallbladder. There are very few cases where cholecystitis appears normal under ultrasound. The main ultrasound features of cholecystitis include gallbladder wall edema, roughness, and an enlarged gallbladder among other radiological changes. Once cholecystitis is diagnosed, it is crucial to undertake active treatment measures, such as aggressive anti-infection treatment, spasmodic pain relief, etc.