A case of renal carbuncle-the role of radionuclides.

There is evidence that renal carbuncle is becoming more common (Rabinowitz 1972). Diagnosis can be difficult, and unless the condition is borne in mind, chronic cases may suppurate slowly with considerable resultant morbidity. We report here a typical longstanding case and discuss the available methods of investigation, including excretion urography, ultrasound, radionuclide scanning and computerassisted tomography. A 19-year-old man was referred to the urology clinic with a two-month history of chronic low back pain and general malaise. Orthopaedic evaluation had revealed no musculoskeletal abnormality but he was tender in the right loin and excretion urography demonstrated enlargement, rotation and questionable displacement of the right kidney, with masking of the psoas shadow. It was unclear if the primary lesion was extrinsic or intrinsic to the kidney, but the possibility of a mass lesion was raised. Although urinalysis was normal, haematological investigation revealed a white cell count of 13.8 × 10...