A 5-year-old black girl with sickle cell anemia had back pain with an associated fever. The clinical diagnosis was bone infarction or osteomyelitis of the spine. A radionuclide bone scan was performed and demonstrated extraosseous uptake in the spleen, which is a common finding in patients with sickle cell anemia. However, in addition, a focal area of abnormal activity in the midupper portion of the right kidney was demonstrated. An ultrasound examination was performed that demonstrated a focal hyperechoic area at the same site. Urine analysis demonstrated an acute pyelonephritis. The child was treated with antibiotics and promptly responded.
From the Department of Radiology, Children's Hospital of Wisconsin, Milwaukee, Wisconsin
Received for publication March 14, 1995; accepted September 5, 1995.
Reprint requests: John R. Sty, M.D., Children's Hospital of Wisconsin, Department of Radiology, #721, 9000 West Wisconsin Avenue, Milwaukee, WI 53226.