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  • Urinary tract infections (UTI)

  • 590.9 Infection of kidney, unspecified

  • 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

  • N15.9 Renal tubulo-interstitial disease, unspecified

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.


  • 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

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 aerobic capacity and muscle endurance
    • Sarcopenia
    • Weakness or impaired muscle performance
    • Musculoskeletal problems
    • Neuromuscular problems
    • Weight loss or weight gain

Functional Implications

  • Severe symptoms, such as urgent need to urinate, may be ...

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