Which area can pyelonephritis cause referred pain?

The correct choice regarding referred pain caused by pyelonephritis is the area associated with the lower back and abdomen. Pyelonephritis, which is an infection of the kidney, typically presents with symptoms that are localized to the flank area and may radiate to the lower back or abdomen due to the anatomical connections between the kidneys, ureters, and the surrounding structures.

In cases of pyelonephritis, the inflammation and infection can irritate the surrounding nerves, which can then create referred pain sensations in the lower back and abdomen. This is consistent with the somatic and visceral pain pathways, where pain from the internal organs can be perceived in more superficial structures. The interplay between the renal and lower back regions explains why individuals with pyelonephritis may experience discomfort in the lower back.

The options involving the neck and shoulder, chest and ribcage, or hip and thigh do not typically align with the patterns of referred pain associated with kidney infections. These areas either represent different pain syndromes or are related to other organic problems not directly associated with renal pathologies. Therefore, the most appropriate area for referred pain from pyelonephritis is indeed the lower back and abdomen.