Findings
The kidney is enlarged with inhomogenous echotexture and loss of corticomedullary differentiation.
Discussion
The edema associated with acute bacterial pyelonephritis causes the ultrasound findings described above. There is a differential for this ultrasonic appearance which includes other infiltrative processes. The patient’s clinical presentation added to the ultrasound findings makes the diagnosis of acute bacterial pyelonephritis.
http://eradiology.bidmc.harvard.edu/Classics/item.aspx?section=Emergency+Radiology&labelpk=33f0adab-853f-4010-a0e2-0756b3f1eac5&pk=7ac826e1-55cb-4fff-b7b3-176c3d38ff41
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