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Condition/Disorder Synonyms

  • Urinary tract infections (UTI)

ICD-9-CM Codes

  • 590.9 Infection of kidney, unspecified

Associated Physical Therapy Diagnoses

  • 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

ICD-10-CM Code

  • N15.9 Renal tubulo-interstitial disease, unspecified

Preferred Practice Pattern

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.

Key Features


  • 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

Essentials of Diagnosis

  • 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)

General Considerations

  • 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


  • 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

Clinical Findings

Signs and Symptoms

  • 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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