Pyelography has become quite an important procedure in determining the cause of vague aches and pains in the flank and in the region of the kidney. If, when the pyelogram is being made, the pain is reproduced by distention of the renal pelvis or ureter, and if then the pyelogram shows the pelvis to be abnormal in any respect, the kidney may be regarded as a possible factor in the production of the pain.
Furthermore, one is especially prone to suspect that the kidney is causing the trouble if it is atrophic. Final decision as to the course of treatment to be undertaken in such cases should be made only after the most careful examination and lengthy observation. This pertains particularly to patients in whom kidneys have been previously explored, incised or "tacked up." Our attention has been directed recently to certain cases in which one finds an atrophie distorted kidney, which
BELCHER GW. RENAL DISTORTIONITS RELATION TO NEPHRALGIA. JAMA. 1927;89(26):2166–2170. doi:10.1001/jama.1927.02690260014004