Ultrasound images of Focal pyelonephritis

The presence of acute infection within the kidney may progress in focal regions of the renal parenchyma. This phenomenon is particularly associated with diabetics.
The ultrasonic changes are subtle, as in diffuse pyelonephritis, but it is possible to detect a slight change in echogenicity when it is surrounded by normal-looking parenchyma.
Focal pyelonephritis (sometimes called focal nephronia) may be either hypo- or hyperechoic compared with normal renal tissue. Depending on the size of the lesion, it may cause a mass effect, mimicking a renal tumour. The outline of the kidney
is preserved, however (Fig.ultrasound images below)
The patient presents with fever and tenderness on the affected side and frequently has a history  of urinary tract infection. A focal renal mass under these circumstances is highly suggestive of focal pyelonephritis and is also well demonstrated on CT.
It usually responds to antibiotic therapy and resolution of the lesion can be monitored with ultrasound scans. Focal pyelonephritis can progress to form an abscess in the kidney, which can normally be treated by percutaneous drainage and antibiotics.
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