Pyelonephritis

Case contributed by Melbourne Uni Radiology Masters
Diagnosis almost certain

Presentation

Flank pain and fevers.

Patient Data

Age: 50 years
Gender: Male

CT Abdomen and pelvis

ct

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.

Case Discussion

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.

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