Presentation of CaseA fifty-six-year-old longshoreman entered the hospital because of pain in the back.During the two months before admission he experienced an intermittent, "dragging" pain bilaterally in the lower portion of the back, with radiation around the iliac crests and inguinal regions into the testes. Each episode of pain lasted for about three hours. Anorexia, malaise, a loss of 10 pounds in weight, night sweats and elevations of the temperature to 99°F. occurred, and "rusty" urine was observed. Four days before entry an intravenous pyelogram demonstrated moderate dilatation of the calyxes of the left kidney and poor visualization . . .
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