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Carl H. June, MD; Mark D. Browning, MD; L. Patrick Smith, MA; Donald J. Wenzel, MD; Robert S. Pyatt, MD; Leonard M. Checchio, MD; E. S. Amis, Jr, MD

Arch Intern Med. 1985;145(5):841-845.

Abstract
• A prospective study evaluated the utility of renal computed tomography (CT) and ultrasonography in 35 patients hospitalized for treatment of urinary tract infection. Renal computed tomograms were abnormal in 18 of 28 patients with acute pyelonephritis and three of four patients with urosepsis, showing findings consistent with pyelonephritis in 17 patients and intrarenal abscess or focal bacterial nephritis in four patients. Renal sonograms were abnormal in only eight patients, showing findings compatible with pyelonephritis in four and intrarenal abscess or focal bacterial nephritis in the other four. Flank tenderness was absent in only four patients with CT findings of pyelonephritis, of whom three were diabetic. We therefore found that (1) renal CT is a sensitive test for acute upper urinary tract infection, (2) ultrasonography detects focal bacterial nephritis and abscesses but is insensitive to uncomplicated upper urinary tract infection, and (3) painless pyelonephritis may be more common in patients with diabetes mellitus.

(Arch Intern Med 1985;145:841-845)

Author Affiliations
From the Departments of Medicine (Drs June and Browning and Mr Smith), Radiology (Drs Wenzel and Pyatt), and Urology (Dr Amis), Naval Hospital; and the Uniformed Services University of the Health Sciences (Drs June, Browning, and Checchio), Bethesda, Md.

Footnotes
Accepted for publication Aug 21, 1984.

The opinions and assertions expressed herein are those of the authors and are not to be construed as official nor as reflecting the views of the Department of the Navy nor of the Department of Defense.

Reprint requests to Fred Hutchinson Cancer Research Center, M734, 1124 Columbia St, Seattle, WA 98104 (Dr June).

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