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CONDITION/DISORDER SYNONYM

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  • Urinary tract infection (UTI)

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ICD-9-CM CODES

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  • 590.9 Infection of kidney, unspecified

  • Associated ICD-9-CM PT diagnoses/treatment diagnosis that may be directly related to urogenital (UG) disorders or consequences from bed rest, surgery, or inactivity or directly related to UG disorders specifically

    • 315.4 Developmental coordination disorder

    • 718.45 Contracture of joint, pelvic region and thigh

    • 719.70 Difficulty in walking

    • 728.2 Muscular wasting and disuse atrophy

    • 728.89 Other disorders of muscle, ligament, and fascia

    • 729.9 Other and unspecified disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 781.2 Abnormality of gait

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

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ICD-10-CM CODE

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  • N15.9 Renal tubulo-interstitial disease, unspecified

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PREFERRED PRACTICE PATTERN

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  • As of June, 2014, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology; therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.1

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PATIENT PRESENTATION

A 29-year-old woman complains of a 2-day history of dysuria, urgency, and urinary frequency. She denies the use of medications and has no significant past medical history. On examination, her blood pressure (BP) is 100/70 mm Hg, heart rate (HR) 90 beats per minute, and temperature 98°F (36.6°C). The thyroid is normal on palpation. The heart and lung examinations are normal. She does not have back tenderness. The abdomen is nontender and without masses. The pelvic examination reveals normal female genitalia. There is no adnexal tenderness or masses.2

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KEY FEATURES

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Description
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  • Can occur in any component of the urinary system: Upper UTIs (kidneys and ureters) and lower UTIs (urethra and bladder)

  • Sudden onset of confusion in elderly without fever

  • Severe pain with or without attempts at urination in males and females or no pain at all, especially in the elderly and children

  • Changes in color, volume (decrease), and odor of urine

  • Most common in bladder and urethra

    • Cystitis

    • Urethritis

  • If spread to kidneys, symptoms more severe, and pain is located in the lower back with possible tenderness to palpation of the kidneys

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Essentials of Diagnosis
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  • Difficulty urinating

  • Painful urination

  • Malodorous urine

  • Pelvic pain in women

  • Rectal pain in men

  • Change in color of urine

  • Positive cultures

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General Considerations
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  • Diagnosis for more occult problems may take time and require intensive medical diagnostic testing

  • May refer pain to back, pelvic region, or rectal area (men)

  • May result in secondary problems such as

    • Aerobic capacity and muscle-endurance impairment

    • Sarcopenia

    • Weakness/impaired muscle performance

    • Musculoskeletal problems

    • Neuromuscular problems

  • May mimic colon cancer or tumors, irritable bowel, colitis, or gynecological problems in females such as endometriosis, uterine fibroids, or ectopic pregnancies

  • May or may not be associated with fever

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FIGURE 61-1

3-D reconstruction. Three-dimensional postprocessed volume-rendered image of the urinary tract ...

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