Faust, Jeremy S.Tsung, James W.2017-02-182017Faust, Jeremy S., and James W. Tsung. 2017. “Eliciting renal tenderness by sonopalpation in diagnosing acute pyelonephritis.” Critical Ultrasound Journal 9 (1): 1. doi:10.1186/s13089-016-0056-6. http://dx.doi.org/10.1186/s13089-016-0056-6.2036-3176http://nrs.harvard.edu/urn-3:HUL.InstRepos:30370986Diagnosing acute pyelonephritis relies on the combination of historical, physical, and laboratory findings. Costovertebral angle tenderness is important, although its accuracy is unknown. Point-of-care ultrasound-guided palpation (sonopalpation) may aid clinicians in localizing pain to discrete anatomic structures in cases of suspected acute pyelonephritis lacking classic features. We describe three low-to-moderate pre-test probability cases wherein maximal tenderness was elicited by renal sonopalpation, aiding in the diagnosis of acute pyelonephritis. In a fourth case, absence of renal tenderness to sonopalpation in a patient exhibiting typical acute pyelonephritis features led to an alternate diagnosis. Therefore, renal sonopalpation may be useful in confirming or refuting suspected cases.en-USEmergency medicinePyelonephritisPoint-of-care ultrasonographySonopalpationJournal Article2017-02-1810.1186/s13089-016-0056-6