What physical exam finding is associated with pyelonephritis?

Costovertebral angle tenderness is a key physical exam finding associated with pyelonephritis. This tenderness is elicited when gentle percussion is applied to the area of the back near the lower ribs, specifically at the costovertebral angle where the kidney is located. In cases of pyelonephritis, which is an infection of the kidney typically resulting from ascending urinary tract infection, inflammation of the kidneys often leads to sensitivity and discomfort in this area. The presence of costovertebral angle tenderness suggests underlying kidney pathology and is a vital indicator that healthcare providers use to clinically assess for renal involvement.

In contrast, abdominal guarding is more indicative of acute abdominal pathology, such as appendicitis or peritonitis, rather than a kidney infection. Pitting edema is usually associated with systemic conditions that cause fluid retention, such as congestive heart failure or hepatic issues, and is not specific to pyelonephritis. Cirrhosis refers to chronic liver disease and does not connect with the symptoms or findings of pyelonephritis. Thus, recognizing costovertebral angle tenderness is essential in the diagnosis and management of pyelonephritis.