Abstract
Background Urinary tract infection (UTI) is considered one of the most frequently occurring bacterial infections; however, its diagnosis is not always straightforward. Nowadays, ultrasonography (US) is the modality of choice in assessment of suspected cases of upper UTIs. Dirty renal sinus fat was diagnosed as irregular-shaped linear hypoechoic streaks that are seen arising from the renal sinus and extending laterally with haziness of the outline of the hyperechoic renal sinus fat. The aim of this study is to document a new simple radiological sign (dirty renal sinus fat) that can help in the diagnosis of UTIs. Patients and methods A cross-sectional study was conducted that included 46 patients visiting Hala Eisa Hospital searching for medical advice who were selected randomly during the period January–April 2019. All the patients were selected after the abdominal US that revealed the dirty renal sinus fat sign or the patients had clinical picture suggesting UTI. The sonographic appearances of all cases were analyzed by the same radiologist who was blinded to the urine culture results that were done for all patients. Results Using urine culture examination, 16 patients had positive urinary infection (two males and 14 females). For males, the two cases diagnosed by urinary examination were diagnosed also by US, in addition to another seven cases, with a sensitivity of 100%, specificity of 66.7%, and area under the curve of 83.3. However, for women, the US examination missed one case from the 14 cases diagnosed by urinary examination, in addition to misdiagnosis of another three cases as positive urinary infection, with a sensitivity of 92.9%, specificity of 66.7%, and area under the curve of 79.8. Conclusion Dirty renal sinus fat is a new reliable US finding that can help the urologist and internal medicine physicians in suspecting UTI as a hidden or unexpected finding that can explain the patient’s complaint.
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