Renal tenderness and percussion pain

Introduction Renal tenderness and pain are one of the clinical manifestations of renal vein thrombosis. Patients with nephrotic syndrome may have thrombosis due to hypercoagulable state of the blood, and their clinical manifestations are also highly individual. RVT may have no special clinical manifestations or some clinical symptoms such as fever (17%), acute low back pain (10% to 64%) and renal tenderness and cramps, sudden hematuria (74%), elevated serum creatinine B-ultrasound found that kidney enlargement (43%) should pay attention to the possibility of RVT when patients with nephrotic syndrome find these symptoms. However, most (75%) RVT has no typical clinical manifestations (chronic or subclinical) and has no significant relationship with the fluctuation of nephrotic syndrome.

Cause

1. Waist pain: The patient feels pain in the waist and kidney area, and can be on one side or both sides. Most of the pain is longer, and it can be aggravated or alleviated by activities or rest.

2, kidney area tenderness: normal people only under pressure when the right kidney is under the pole, there will be discomfort or a little painful feeling.

3, kidney area pain: kidney area pain positive often suggest that the kidney including the surrounding tissue of the kidney inflammation, kidney tuberculosis, hydronephrosis, stone tumors and so on.

an examination

Related inspection

Single-phase agar diffusion test for retroperitoneal angiography

Kidney pain can be asymptomatic in the early stage. The primary infection may have been neglected. Later, there is renal pain, sudden onset, accompanied by chills, high fever, poor appetite and other bacteremia or toxemia. On one side, renal pain, tenderness, tenderness and tenderness may occur, and sometimes the back pain may be affected by low back pain, and the swollen kidney may be touched, and the waist muscles are tight.

Differential diagnosis

It should be differentiated from other embolic diseases, such as renal artery thrombosis and embolism and other causes of kidney disease.

Renal artery thrombosis and embolization refers to the complete occlusion of the renal artery lumen due to vascular wall factors or blood factors due to vascular wall factors or large branches, causing renal dysfunction, transient hypertension, renal pain and renal tissue deficiency. Bloody necrosis. The patient is mainly characterized by a series of clinical syndromes such as fever, changes in urine routine, and increased cell enzymology. In the past, there have been few reports in clinical practice. In recent years, with the development of radiological interventional diagnosis and treatment techniques, the diagnostic rate of renal infarction has increased.

The clinical diagnosis of renal vein thrombosis has certain difficulties. The rate of missed diagnosis is high. Physicians must improve the vigilance of patients with pathogenic factors of renal vein thrombosis. Any of the following conditions should be further assisted to confirm the diagnosis:

1. Sudden onset of severe low back pain.

2. It is difficult to explain the increase in hematuria.

3. Unexplained increase in urine protein.

4. Difficult to explain the sharp decline in renal function.

5. Asymmetrical lower extremity edema.

6. Patients with nephrotic syndrome have refractory hormone resistance.

7. Patients with nephrotic syndrome have pulmonary embolism or embolization at other sites. Combined with laboratory examination and imaging examination, the diagnosis of renal vein thrombosis can be made according to the characteristics of this disease.

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