Elevating

Renal & Urinary System


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This middle-aged man has presented with fever in association with left upper quadrant pain, while the examination is significant for tenderness of the left hypochondrium and lumbar region, and most concerningly, ipsilateral renal angle tenderness.\n \nThis should be considered a case of acute pyelonephritis until proven otherwise, especially given the history of previous urosepsis; urinalysis, urine cultures, and ultrasound imaging of the abdomen are essential first-line investigations.\n \nInterestingly though, urinalysis is normal. However, ultrasound reveals a hypoechoic collection detected, surrounding the left kidney but separated from it by a thick wall. Could this be a perinephric abscess? \n \nIn turn, computed tomography (CT) confirms th"}]}

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