Pyelonephritis other diagnostic studies: Difference between revisions

Jump to navigation Jump to search
(Category)
Line 4: Line 4:


==Overview==
==Overview==
Other diagnostic studies for pyelonephritis include contrast nephrograms, intravenous pyleography, voiding cystourethrogram, dimercaptosuccinic acid scintigraphy, histopathological exam, and urography.  
Other diagnostic studies for pyelonephritis include voiding cystourethrogram, dimercaptosuccinic acid scintigraphy, and histopathological exam.  


==Other Diagnostic Studies==
==Other Diagnostic Studies==
===Contrast Nephrograms===
====Acute Pyelonephritis====
*Acute pyelonephritis consists of focal areas of striated or wedge-shaped [[hypoperfusion]], resulting in a characteristic striated nephrogram.
*Striations result from stasis of contrast material within edematous tubules that demonstrates increasing attenuation over time.
*The infected [[kidney]] is usually enlarged, and there is often stranding in the [[perinephric fat]].
*Delayed views of the infected [[kidney]] may demonstrate a [[nephrogram]] with increased attenuation.
===Intravenous Pyelography===
Intravenous pyelography ([[IVP]]) is a very sensitive readiological test and is performed to diagnose an intrarenal or perinephric abscesses. It can also be used to assess the normal functioning of the urinary passage.<ref name="pmid6992728">{{cite journal| author=Hoverman IV, Gentry LO, Jones DW, Guerriero WG| title=Intrarenal abscess. Report of 14 cases. | journal=Arch Intern Med | year= 1980 | volume= 140 | issue= 7 | pages= 914-6 | pmid=6992728 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6992728  }} </ref>
===Voiding cystourethrogram (VCUG)===
A VCUG is an x ray image of the [[bladder]] and [[urethra]] taken while the bladder is full and during urination (also known as voiding). The procedure is performed in an outpatient center or hospital by an x ray technician supervised by a radiologist, who then interprets the images. Anesthesia is not needed, but sedation may be used. The bladder and [[urethra]] are filled with contrast medium to make the structures clearly visible on the radiographs. The x ray machine captures images of the contrast medium while the bladder is full and when the person urinates. This test can demonstrate abnormalities of the inside of the urethra and bladder and is usually used to detect [[VUR]] in children.<ref name="pmid27689111">{{cite journal| author=Yousefichaijan P, Dorreh F, Shahsavari S, Pakniyat A| title=Comparing between results and complications of doing voiding cystourethrogram in the first week following urinary tract infection and in 2-6 weeks after urinary tract infection in children referring to a teaching hospital. | journal=J Renal Inj Prev | year= 2016 | volume= 5 | issue= 3 | pages= 144-7 | pmid=27689111 | doi=10.15171/jrip.2016.30 | pmc=5040001 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27689111  }} </ref>
===Dimercaptosuccinic acid (DMSA) scintigraphy===  
===Dimercaptosuccinic acid (DMSA) scintigraphy===  


Line 26: Line 13:
===Histopathological exam===
===Histopathological exam===
Xanthoranulomatous pyelonephritis is usually confused with a [[malignancy]] and surgery is performed. The histopathological examination of the resected specimen confirms xanthogranulomatous pyelonephritis which is not a very common phenomenon. Microscopic examination after performing [[biopsy]] shows the inflammatory mass composed of [[lipid-laden]] [[macrophages]] and chronic inflammatory cells.<ref name="pmid27915241">{{cite journal| author=Yeow Y, Chong YL| title=Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess. | journal=J Surg Case Rep | year= 2016 | volume= 2016 | issue= 12 | pages=  | pmid=27915241 | doi=10.1093/jscr/rjw211 | pmc=5159021 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27915241  }} </ref>
Xanthoranulomatous pyelonephritis is usually confused with a [[malignancy]] and surgery is performed. The histopathological examination of the resected specimen confirms xanthogranulomatous pyelonephritis which is not a very common phenomenon. Microscopic examination after performing [[biopsy]] shows the inflammatory mass composed of [[lipid-laden]] [[macrophages]] and chronic inflammatory cells.<ref name="pmid27915241">{{cite journal| author=Yeow Y, Chong YL| title=Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess. | journal=J Surg Case Rep | year= 2016 | volume= 2016 | issue= 12 | pages=  | pmid=27915241 | doi=10.1093/jscr/rjw211 | pmc=5159021 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27915241  }} </ref>
===Urography===
Urography can be used to diagnose patients with acute pyelonephritis and in some cases with xanthogranulomatous pyelonephritis:<ref name="pmid2724423">{{cite journal| author=Sandberg T, Stokland E, Brolin I, Lidin-Janson G, Svanborg Edén C| title=Selective use of excretory urography in women with acute pyelonephritis. | journal=J Urol | year= 1989 | volume= 141 | issue= 6 | pages= 1290-4 | pmid=2724423 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2724423  }} </ref>
* Classic urographic triad in diffuse xanthogranulomatous pyelonephritis consists of unilaterally decreased or (more commonly) absent renal excretion, a [[staghorn calculus]], and a poorly defined mass or diffuse renal enlargement.
*Failure to respond to [[antibiotic therapy]] or recurrence of symptoms may be taken as an indication to perform [[urography]].


==References==
==References==

Revision as of 21:40, 11 June 2018

Urinary Tract Infections Main Page

Pyelonephritis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pyelonephritis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocaridogram

X Ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pyelonephritis other diagnostic studies On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pyelonephritis other diagnostic studies

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pyelonephritis other diagnostic studies

CDC on Pyelonephritis other diagnostic studies

Pyelonephritis other diagnostic studies in the news

Blogs on Pyelonephritis other diagnostic studies

Directions to Hospitals Treating Pyelonephritis

Risk calculators and risk factors for Pyelonephritis other diagnostic studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Other diagnostic studies for pyelonephritis include voiding cystourethrogram, dimercaptosuccinic acid scintigraphy, and histopathological exam.

Other Diagnostic Studies

Dimercaptosuccinic acid (DMSA) scintigraphy

DMSA scintigraphy is based on the identification of radiation in minute quantities after injecting a radioactive material. Since the radioactive material is used in a minute quantity, there is less risk of cell damage. It can be performed in an outpatient or inpatient setting by qualified personnel. This investigation can be carried out in the absence of anesthesia. Radioactive substance injected an arm vein reaches the kidneys. Attached cameras create images of the path taken by the radioactive substance. The effected parts of the kidney become prominent. DMSA scintigraphy shows the extent of kidney involvement. Cortical Scintigraphy is preferred for the diagnosis of acute pyelonephritis in children.[1][2][3]

Histopathological exam

Xanthoranulomatous pyelonephritis is usually confused with a malignancy and surgery is performed. The histopathological examination of the resected specimen confirms xanthogranulomatous pyelonephritis which is not a very common phenomenon. Microscopic examination after performing biopsy shows the inflammatory mass composed of lipid-laden macrophages and chronic inflammatory cells.[4]

References

  1. Salihoglu YS, Elri T, Gulle K, Can M, Aras M, Ozacmak HS; et al. (2016). "Evaluation of the protective effect of agmatine against cisplatin nephrotoxicity with 99mTc-DMSA renal scintigraphy and cystatin-C". Ren Fail. 38 (9): 1496–1502. doi:10.1080/0886022X.2016.1227919. PMID 27604130.
  2. Benador D, Benador N, Slosman DO, Nusslé D, Mermillod B, Girardin E (1994). "Cortical scintigraphy in the evaluation of renal parenchymal changes in children with pyelonephritis". J Pediatr. 124 (1): 17–20. PMID 8283371.
  3. Kawashima A, LeRoy AJ (2003). "Radiologic evaluation of patients with renal infections". Infect Dis Clin North Am. 17 (2): 433–56. PMID 12848478.
  4. Yeow Y, Chong YL (2016). "Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess". J Surg Case Rep. 2016 (12). doi:10.1093/jscr/rjw211. PMC 5159021. PMID 27915241.