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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  
*High blood pressure
*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

  1. Colgan R, Williams M, Johnson JR (2011). "Diagnosis and treatment of acute pyelonephritis in women". Am Fam Physician. 84 (5): 519–26. PMID 21888302.
  2. 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.
  3. 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.
  4. 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.

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