To confirm pyelonephritis in a patient, what test may be particularly sensitive?

When confirming pyelonephritis, the renal punch test, also known as kidney punch or costovertebral angle tenderness test, is particularly sensitive. This test involves tapping or striking the area over the kidney at the costovertebral angle, usually at the lower back, to elicit tenderness. In patients with pyelonephritis, this maneuver typically results in significant discomfort, indicating potential kidney inflammation or infection.

In contrast, other tests mentioned do not specifically pertain to confirming pyelonephritis. Morton's test is used for diagnosing neuromas or issues related to the metatarsal area of the foot. Murphy’s test, although related to abdominal pain, primarily assesses gallbladder inflammation. Romberg's test is used to evaluate balance and proprioception, typically in neurology, and does not indicate renal issues. Thus, the renal punch test is the most appropriate choice for diagnosing pyelonephritis due to its direct relevance to renal tenderness and infection assessment.