Does Ultrasound have a role in evaluating pyelonephritis?
Sonographic imaging of the kidneys is usually reserved for refractory rather than acute cases of pyelonephritis, in order to search for potential complications such as renal abscess formation. Most patients with acute pyelonephritis have normal-appearing kidneys on US. When present, sonographic features that can be seen with pyelonephritis include increased renal size, compression of the renal sinus, variable change in renal echotexture (hypoechoic to hyperechoic), poorly marginated foci, loss of corticomedullary differentiation, focal or diffusely decreased renal perfusion, and/or renal parenchymal gas.
