Differential Diagnosis for Symmetric Renal Enhancement and Nonspecific Perinephric Stranding Bilaterally

• Single Most Likely Diagnosis
  • Acute Pyelonephritis: This condition is characterized by an infection of the renal parenchyma and is a common cause of symmetric renal enhancement and perinephric stranding due to inflammation and edema.
• Other Likely Diagnoses
  • Acute Interstitial Nephritis: This condition involves inflammation of the spaces between the renal tubules and can cause symmetric renal enhancement and perinephric stranding due to edema and inflammation.
  • Bilateral Renal Vein Thrombosis: Although less common, this condition can cause symmetric renal enhancement due to venous congestion and perinephric stranding due to hemorrhage or edema.
  • Systemic Lupus Erythematosus (SLE) with Renal Involvement: SLE can cause a variety of renal manifestations, including symmetric renal enhancement and perinephric stranding due to inflammation and immune complex deposition.
• Do Not Miss Diagnoses
  • Sepsis with Renal Involvement: Sepsis can cause symmetric renal enhancement and perinephric stranding due to hypoperfusion, inflammation, and potential for abscess formation. Missing this diagnosis could be fatal.
  • Bilateral Renal Infarction: Although less common, this condition can cause symmetric renal enhancement and perinephric stranding due to ischemia and infarction. Prompt diagnosis is crucial for potential intervention.
• Rare Diagnoses
  • Lymphoma with Renal Involvement: Lymphoma can cause symmetric renal enhancement and perinephric stranding due to tumor infiltration and inflammation, although this is a less common presentation.
  • Sarcoidosis with Renal Involvement: Sarcoidosis can cause granulomatous inflammation in the kidneys, leading to symmetric renal enhancement and perinephric stranding, although this is a rare manifestation.