Imaging in inflammatory disease of the kidney

The evaluation and management of patients with severe persistent urinary tract infection after appropriate antibiotic therapy can be difficult. The first radiologic examination is usually excretory urography, but the findings often are nonspecific. A group of 40 patients was studied to assess the contribution of cross-sectional imaging and included patients with diffuse and focal pyelonephritis, renal abscess, pyonephrosis, and pararenal abscess. Indications for cross-sectional imaging include persistent symptoms despite antibiotics, predisposing "risk factors," suspicion of flank mass on other imaging methods, and no excretion on urography. Percutaneous aspiration and/or drainage for diagnosis and/or treatment can be guided by the cross-sectional imaging methods.