Pediatric Chronic Pyelonephritis

Etiology: Complication of one or many episodes of acute pyelonephritis
Imaging:
— Ipsilateral renal cortical thinning, renal scarring and renal atrophy resulting in overall renal asymmetry
— Contralateral renal compensatory hypertrophy
DDX:
Complications:
Treatment:
Clinical:

Radiology Cases of Chronic Pyelonephritis

Radiology Cases of Right Sided Chronic Pyelonephritis

CT of reflux nephropathy and VCUG of vesicoureteral reflux — Coronal CT with contrast of the abdomen (left) shows a normal appearing left kidney and a shrunken right kidney with diffuse loss of renal parenchyma and scarring. AP image from a voiding cystourethrogram (right) shows left grade II vesicoureteral reflux and right grade IV vesicoureteral reflux.

Radiology Cases of Left Sided Acute Pyelonephritis and Left Sided Chronic Pyelonephritis

CT of acute pyelonephritis and chronic pyelonephritis in the same kidney — Axial CT with contrast of the abdomen (above) shows the left kidney to have a striated nephrogram appearance with multiple wedge-shaped areas of low density in the left kidney. Coronal CT (below) shows the low density areas are in the upper pole of the left kidney. The lower pole of the left kidney is shrunken and scarred.

Radiology Cases of Right Sided Chronic Pyelonephritis and Left Sided Acute Pyelonephritis

CT of acute pyelonephritis and chronic pyelonephritis — Coronal (above) and axial (below) CT with contrast of the abdomen shows multiple peripheral wedge-shaped areas of low density in the upper and middle left kidney. The right kidney is noted to be significantly smaller in size than the left kidney.