Pediatric Radiology

, Volume 24, Issue 3, pp 210–212 | Cite as

Xanthogranulomatous pyelonephritis in childhood: Ultrasound and CT diagnosis

  • C. Cousins
  • J. Somers
  • N. Broderick
  • C. Rance
  • D. Shaw


Four cases of diffuse xanthogranulomatous pyelonephritis (XPN) in young children are presented. In three patients the clinical picture was one of weight loss, anaemia and neutrophilia with a large renal mass. The fourth presented with haematuria. Ultrasound (US) and CT findings were almost identical in all four patients. US showed the affected kidney was massively enlarged but retained a reniform shape. Dilated fluid spaces containing calculi were present. CT confirmed the US findings and revealed peripheral enhancement without contrast excretion, with dilated calyceal spaces producing the “bear paw sign”. Extrarenal extension into abdominal wall and psoas muscle is typical and was well demonstrated by CT. The affected kidneys were non-functioning and nephrectomy was required. Typical US and CT features allow a confident diagnosis of XPN and appropriate early treatment.


Abdominal Wall Early Treatment Clinical Picture Pyelonephritis Renal Mass 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Parker MD, Clark RL (1989) Evolving concepts in the diagnosis of xanthogranulomatous pyelonephritis. Urol Radiol 11: 7–15PubMedGoogle Scholar
  2. 2.
    Tolia BM, Iloreta A, Freed SZ, Fruchtman B, Bennett B, Newman HR (1981) Xanthogranulomatous pyelonephritis: detailed analysis of 29 cases and a brief discussion of atypical presentations. J Urol 126: 437–442PubMedGoogle Scholar
  3. 3.
    Braun G, Moussali L, Balanzar JL (1985) Xanthogranulomatous pyelonephritis in children. J Urol 133: 236–239PubMedGoogle Scholar
  4. 4.
    Graiver L, Vargas MA (1972) Xanthogranulomatous pyelonephritis in childhood. Am J Dis Child 123: 156–158PubMedGoogle Scholar
  5. 5.
    Goldman SM, Hartman DS, Fishman EK, Finizio JP, Gatewood OMB, Siegelman SS (1984) CT of xanthogranulomatous pyelonephritis: radiologic-pathologic correlation. AJR 141: 963–969Google Scholar
  6. 6.
    Hughes PM, Gupta SC, Thomas NB (1990) Case report: xanthogranulomatous pyelonephritis in childhood. Clin Radiol 41: 360–362CrossRefPubMedGoogle Scholar
  7. 7.
    Zafaranloo S, Gerard PS, Bryk D (1990) Xanthogranulomatous pyelonephritis in children: analysis by diagnostic modalities. Urol Radiol 12: 18–21PubMedGoogle Scholar
  8. 8.
    Bagley FH, Stewart AM, Jones PF (1977) Diffuse xanthogranulomatous pyelonephritis in children: an unrecognised varian. J Urol 18: 434–435Google Scholar
  9. 9.
    Garel L, Brunelle F, Montagne J (1979) Les pyelonephrites xanthogranulomateuses de l'enfant. Ann Radiol 22: 207–212PubMedGoogle Scholar
  10. 10.
    Malek RS, Elder JS (1978) Xanthogranulomatous pyelonephritis: a critical analysis of 26 cases and of the literature. J Urol 119: 589–593PubMedGoogle Scholar
  11. 11.
    Hartman DS, Davis CJ, Goldman SM, Isbister SS, Saunders RC (1984) Xanthogranulomatous pyelonephritis: sonographic-pathologic correlation of 16 cases. J Ultrasound Med 3: 481–488PubMedGoogle Scholar
  12. 12.
    Van Kirk OC, Go RT, Wedel VJ (1980) Sonographic features of xanthogranulomatous pyelonephritis. AJR 134: 1035–1039PubMedGoogle Scholar
  13. 13.
    Subramanyam BR, Megibow AJ, Raghavendra NB, Bosniak MA (1982) Diffuse xanthogranulomatous pyelonephritis: analysis by computed tomography and sonography. Urol Radiol 4: 5–9PubMedGoogle Scholar
  14. 14.
    Abbate AD, Meyers J (1976) Xanthogranulomatous pyelonephritis in childhood. J Urol 116: 231–233PubMedGoogle Scholar
  15. 15.
    Kenney PJ (1990) Imaging of chronic renal infections. AJR 155: 485–494PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • C. Cousins
    • 1
  • J. Somers
    • 1
  • N. Broderick
    • 1
  • C. Rance
    • 1
  • D. Shaw
    • 2
  1. 1.City HospitalNottinghamUK
  2. 2.Hospital for Sick ChildrenLondonUK

Personalised recommendations