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Enlarged right kidney with striated nephrogram is consistent with pyelonephritis. In pyelonephritis, the kidneys often appear normal with kidneys that could be enlarged due to edema. There may be lower attenuation of the affected kidney. Perinephric stranding is also a finding that may be present. Post contrast, as visualized in this image, one can see focal or wedge-like areas of hypodensity (striated nephrogram) if in excretory phase.

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What is your diagnosis in this case with a patient presenting with a fever and abdominal pain?

Image IQ Quiz: Patient Presents with Fever and Abdominal Pain