Eliciting renal tenderness by sonopalpation in diagnosing acute pyelonephritis
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- 作者：Jeremy S. Faust ; James W. Tsung
- 关键词：Emergency medicine ; Pyelonephritis ; Point ; of ; care ultrasonography ; Sonopalpation
- 刊名：Critical Ultrasound Journal
- 出版年：2017
- 出版时间：December 2017
- 年：2017
- 卷：9
- 期：1
- 全文大小：862KB
- 刊物主题：Emergency Medicine; Ultrasound; Intensive / Critical Care Medicine; Diagnostic Radiology; Imaging / Radiology; Interventional Radiology;
- 出版者：Springer Milan
- ISSN：2036-7902
- 卷排序：9
文摘
Diagnosing acute pyelonephritis relies on the combination of historical, physical, and laboratory findings. Costovertebral angle tenderness is important, although its accuracy is unknown. Point-of-care ultrasound-guided palpation (sonopalpation) may aid clinicians in localizing pain to discrete anatomic structures in cases of suspected acute pyelonephritis lacking classic features. We describe three low-to-moderate pre-test probability cases wherein maximal tenderness was elicited by renal sonopalpation, aiding in the diagnosis of acute pyelonephritis. In a fourth case, absence of renal tenderness to sonopalpation in a patient exhibiting typical acute pyelonephritis features led to an alternate diagnosis. Therefore, renal sonopalpation may be useful in confirming or refuting suspected cases.