Pyonephrosis physical examination
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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]
Overview
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
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[4]
- Palpable abdominal mass[5]
- 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.
- ↑ Takao A, Nakayama Y, Ichikawa T, Saegusa M, Asano S, Aramaki K (2001). "[Septic shock due to pyonephrosis-calculosa: a case report]". Nihon Hinyokika Gakkai Zasshi. 92 (4): 530–3. doi:10.5980/jpnjurol1989.92.530. PMID 11449705.
- ↑ 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.