Eliciting renal tenderness by sonopalpation in diagnosing acute pyelonephritis

Jeremy S. Faust, James W. Tsung

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Diagnosing acute pyelonephritis relies on the combination of historical, physical, and laboratory findings. Costovertebral angle tenderness is important, although its accuracy is unknown. Point-of-care ultrasound-guided palpation (sonopalpation) may aid clinicians in localizing pain to discrete anatomic structures in cases of suspected acute pyelonephritis lacking classic features. We describe three low-to-moderate pre-test probability cases wherein maximal tenderness was elicited by renal sonopalpation, aiding in the diagnosis of acute pyelonephritis. In a fourth case, absence of renal tenderness to sonopalpation in a patient exhibiting typical acute pyelonephritis features led to an alternate diagnosis. Therefore, renal sonopalpation may be useful in confirming or refuting suspected cases.

Original languageEnglish
Article number1
JournalCritical Ultrasound Journal
Issue number1
StatePublished - 1 Dec 2017


  • Emergency medicine
  • Point-of-care ultrasonography
  • Pyelonephritis
  • Sonopalpation


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