Urothelial Thickening on Renal POCUS Teenager (female) with flank pain and fever. POCUS to evaluate for obstructive uropathy. Findings/diagnosis? Patient has minimal pelvicaliectasis but no definitive stone seen. Has urothelial thickening. Can be seen in infections, UCC, inflammatory conditions (including recently passed stone). E.coli pyelonephritis. Prox ureter and a calyce outlined between arrows with wall thickening. US commonly normal in uncomplicated pyelonephritis but can find pyonephrosis, urothelial thickening, focal abnormal echogencity, renal infarction/abscess, perinephric fluid collections, air (emphysematous). What if this was 2-24month old with first febrile UTI? 2015 study demonstrated that urothelial thickening as isolated finding on u/s in young peds patient improves detection of VUR and presence warrants VCUG. Labeled Schematic: https://twitter.com/RJonesSonoEM/st Dr. Robert Jones @RJonesSonoEM #Urothelial #Thickening #Renal #POCUS #clinical #ultrasound
