Pyonephrosis physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
The following features can be found during a physical examination of a patient with pyonephrosis with the patient lying in supine position. | The following features can be found during a physical examination of a patient with pyonephrosis with the patient lying in supine position.<ref name="pmid21888302">{{cite journal| author=Colgan R, Williams M, Johnson JR| title=Diagnosis and treatment of acute pyelonephritis in women. | journal=Am Fam Physician | year= 2011 | volume= 84 | issue= 5 | pages= 519-26 | pmid=21888302 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21888302 }} </ref> | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
*A patient with pyonephrosis is usually in distress. | *A patient with pyonephrosis is usually in distress. | ||
*Patient may have hands on abdomen or back at the area of tenderness. | *Patient may have their hands on the abdomen or back at the area of tenderness. | ||
===Vital Signs=== | ===Vital Signs=== | ||
*Fever may be present | *Fever may be present | ||
*Hypotension<ref name="pmid16440727">{{cite journal| author=Sakai H, Tomita Y| title=[A case of pyonephrosis with septic shock in a hemodialysis patient treated successfully by retroperitoneal drainage]. | journal=Hinyokika Kiyo | year= 2005 | volume= 51 | issue= 12 | pages= 801-3 | pmid=16440727 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16440727 }} </ref> | |||
*Hypotension | |||
===Skin=== | ===Skin=== | ||
| Line 40: | Line 39: | ||
*Costovertebral angle tenderness | *Costovertebral angle tenderness | ||
*Positive sonopalpation test of the kidney | *Positive sonopalpation test of the kidney<ref name="pmid28050884">{{cite journal| author=Faust JS, Tsung JW| title=Eliciting renal tenderness by sonopalpation in diagnosing acute pyelonephritis. | journal=Crit Ultrasound J | year= 2017 | volume= 9 | issue= 1 | pages= 1 | pmid=28050884 | doi=10.1186/s13089-016-0056-6 | pmc=5215196 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28050884 }} </ref> | ||
*Palpable abdominal mass<ref name="pmid25105051">{{cite journal| author=Erol A, Coban S, Tekin A| title=A giant case of pyonephrosis resulting from nephrolithiasis. | journal=Case Rep Urol | year= 2014 | volume= 2014 | issue= | pages= 161640 | pmid=25105051 | doi=10.1155/2014/161640 | pmc=4106088 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25105051 }} </ref> | |||
*Suprapubic tenderness | *Suprapubic tenderness | ||
Revision as of 15:30, 16 October 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Harsh Vardhan Chawla, M.B.B.S.[2]
Physical Examination
The following features can be found during a physical examination of a patient with pyonephrosis with the patient lying in supine position.[1]
Appearance of the Patient
- A patient with pyonephrosis is usually in distress.
- Patient may have their hands on the abdomen or back at the area of tenderness.
Vital Signs
- Fever may be present
- Hypotension[2]
Skin
- Skin examination of patients with pyonephrosis is usually normal.
HEENT
- HEENT examination of patients with pyonephrosis is usually normal.
Neck
- Neck examination of patients with pyonephrosis is usually normal.
Lungs
- Pulmonary examination of patients with pyonephrosis is usually normal.
Heart
- Tachycardia
Abdomen
- Costovertebral angle tenderness
- Positive sonopalpation test of the kidney[3]
- Palpable abdominal mass[4]
- Suprapubic tenderness
Digital rectal examination (DRE).
- DRE helps to differentiate if the obstruction is due to obstruction due to an enlarged prostate gland in men.
Back
- Costovertebral angle tenderness
Genitourinary
The following findings may be found on genitourinary examination of a patient with pyelonephritis:
- Suprapubic tenderness
- Examination of the scrotum and the pubic area must be done
Neuromuscular
- Patient is usually oriented to persons, place, and time.
Extremities
- Extremities examination of patients with pyonephrosis is usually normal.
References
- ↑ Colgan R, Williams M, Johnson JR (2011). "Diagnosis and treatment of acute pyelonephritis in women". Am Fam Physician. 84 (5): 519–26. PMID 21888302.
- ↑ Sakai H, Tomita Y (2005). "[A case of pyonephrosis with septic shock in a hemodialysis patient treated successfully by retroperitoneal drainage]". Hinyokika Kiyo. 51 (12): 801–3. PMID 16440727.
- ↑ Faust JS, Tsung JW (2017). "Eliciting renal tenderness by sonopalpation in diagnosing acute pyelonephritis". Crit Ultrasound J. 9 (1): 1. doi:10.1186/s13089-016-0056-6. PMC 5215196. PMID 28050884.
- ↑ Erol A, Coban S, Tekin A (2014). "A giant case of pyonephrosis resulting from nephrolithiasis". Case Rep Urol. 2014: 161640. doi:10.1155/2014/161640. PMC 4106088. PMID 25105051.