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Condition/Disorder Synonyms

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  • Urinary tract infections (UTI)

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ICD-9-CM Codes

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  • 590.9 Infection of kidney, unspecified

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Associated Physical Therapy Diagnoses

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  • 315.4 Developmental coordination disorder (clumsiness, dyspraxia and/or specific motor development 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 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 January, 2013, 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.

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Key Features

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Description

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  • Kidney and renal pelvis infection

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

  • Pain in the low back with possible tenderness to palpation of the kidneys

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Essentials of Diagnosis

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  • May be indicative of serious medical conditions

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

  • Recognize the possibility of UG pathology in the differential diagnosis process, especially when findings are not consistent with conditions commonly treated (i.e., musculoskeletal, neuromuscular, integumentary, cardiopulmonary)

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General Considerations

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

  • Possible referred pain to back, pelvic region, or rectal area (in men)

  • Symptoms are frequently referred to the back and abdominal areas, so it may be common to have patients inappropriately referred to PT

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Demographics

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  • Females more susceptible than males to cystitis secondary to the anatomical proximity of the urethra to the anus and the bladder

  • Females more susceptible than males to urethritis because of anatomical proximity of the urethra to the vagina; urethritis can also be caused by sexually transmitted diseases (e.g., herpes, gonorrhea, chlamydia)

  • Approximately 50% of all women will have a urinary tract infection (UTI) in their lifetimes

  • Children are at greater risk, with ~ 3% annually having a UTI

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Clinical Findings

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Signs and Symptoms

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  • Urethra (urethritis)

    • Burning with urination

    • Difficulty urinating

  • Bladder (cystitis)

    • Pelvic pressure

    • Lower abdomen discomfort

    • Frequent, painful urination

    • Blood in urine

  • Kidneys (acute pyelonephritis)

    • Upper back and side (flank) pain

    • High fever

    • Shaking and chills

    • Nausea

    • Vomiting

    • Painful urination

    • Malodorous urine

    • Change in color of urine

    • Positive cultures

  • Possible secondary problems may, depending on severity, indicate the need for physical therapy intervention

    • Impairment of ...

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