Flank pain and fevers.
CT Abdomen and pelvis
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There is fat stranding, swelling and reduced perfusion around the upper pole of the left kidney with no collection.
The right kidney is normal in appearance apart from a 14mm exophytic upper pole simple cyst. No renal or ureteric calculus. No hydronephrosis.
Fatty infiltration of the liver. The spleen, pancreas and adrenals are normal in appearance. The bowel is unremarkable. The imaged lung bases are clear.
Conclusion: Findings most in keeping with left pyelonephritis. No ureteric calculus.
In a patient with fevers and flank pain, the CT findings are in keeping with the diagnosis of a non-complicated pyelonephritis: fat stranding, swelling and reduced perfusion around the upper pole of the left kidney with no collection.
Follow-up, in this case, is best done with renal ultrasound.