Combined radiographic and ultrasonographic approach in diagnosis of renal inflammatory lesions.

Seven cases of inflammatory lesions of the kidneys are reported. In 6 of the 7 patients, there were clinical and/or laboratory signs of urinary tract infection. The lesions occurred without any preference to age, sex, or location as to the right or left kidney. The diagnostic approach was individualized, and a correct preoperative diagnosis was made in 6 of the 7 cases. This high diagnostic accuracy was reached by using the following diagnostic principles. The lesions are detected and localized by urography and nephrotomography. Ultrasonography is used to decide whether the mass is solid or cystic. A percutaneous needle puncture is done in cases in which ultrasonography indicates a cystic lesion. The diagnosis of renal cyst is confirmed or excluded by cytology and analysis of the cyst fluid. Renal angiography is performed when the mass displays a solid or mixed ultrasonographic pattern and also in cases of hematuria and in cases in which the clinical symptomatology suggests malignancy.