10-year-old male presents with CVA tenderness, concern for pyelonephritis. KIDNEYS  Cortical Echogenicity: Normal   Medullary Echogenicity: Normal   Pelvicaliceal System -- SFU Grade*  Right: 0 Left: 0  Length*** Right: 14.6 cm Left: 12.9 cm   Mean for age: 9 cm  Range for age: 7.5 - 11 cmADDITIONAL OBSERVATIONS: Right ureteral jet is observed.
Asymmetric enlargement of the right kidney without abnormal echogenicity of the renal parenchyma. No evidence of hydronephrosis. Findings may reflect pyelonephritis in the appropriate clinical setting.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning.Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469