61: URINARY TRACT INFECTION

CONDITION/DISORDER SYNONYM

• Urinary tract infection (UTI)

ICD-9-CM CODES

• 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

ICD-10-CM CODE

• N15.9 Renal tubulo-interstitial disease, unspecified

PREFERRED PRACTICE PATTERN

• 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

KEY FEATURES

Description

• 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

Essentials of Diagnosis

• Difficulty urinating

• Painful urination

• Malodorous urine

• Pelvic pain in women

• Rectal pain in men

• Change in color of urine

• Positive cultures

General Considerations

• 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