title: [Usefulness of ultrasonography in the assessment of acute pyelonephritis].
abstract: OBJECTIVE
  The diagnosis of acute pyelonephritis (APN) is based fundamentally on the clinical and bacteriological findings. Radiology is useful in ruling out obstructive causes that often require surgical management. The present study analyzed the role of renal ultrasonography (US) in patients with clinical symptoms, signs and history compatible with APN that have normal plain abdominal x-rays.
  
  
  METHODS
  87 patients who consulted our emergency services with symptoms and signs compatible with APN were reviewed. Patients who referred renal colic and those with a previous history of urological disease other than uncomplicated recurrent urinary tract infection were excluded. Patients with a plain abdominal x-ray compatible with lithiasis were excluded. Renal US evaluation was performed by the urologist to rule out hydronephrosis.
  
  
  RESULTS
  37 (42.5%) of the 87 patients had an abnormal US scan. These patients were evaluated again by US or IVP, or both (one case). Obstructive uropathy was demonstrated in only 5 cases (5.8%). These foregoing 5 patients were treated by surgery.
  
  
  CONCLUSIONS
  In our series, renal US evaluation indicated surgical treatment in 5.8% of patients with clinical features of APN and a plain abdominal x-ray with no evidence of lithiasis. This incidence is likely to be lower in the outpatient setting. It is difficult to propose a standard approach in the management of these patients. It may therefore be more reasonable to utilize US and IVP in those patients who do not respond to antibiotic therapy.
authors.affiliation: Servicio de Urología, Hospital Universitario de Getafe, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Luján Galán
authors.forename: A
authors.initials: A
authors.lastname: Páez Borda
authors.forename: I
authors.initials: I
authors.lastname: Fernández González
authors.forename: C
authors.initials: C
authors.lastname: Llorente Abarca
authors.forename: I
authors.initials: I
authors.lastname: Romero Cajigal
authors.forename: S
authors.initials: S
authors.lastname: Bustamante Alarma
authors.forename: A
authors.initials: A
authors.lastname: Berenguer Sánchez
mesh_terms: D000208:Acute Disease; D000328:Adult; D000465:Algorithms; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000000981:diagnostic imaging*; D014463:Ultrasonography