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The identification of pyelonephritis, which is an infection of the kidneys, is most commonly achieved through a urinalysis. This test is crucial for diagnosing urinary tract infections (UTIs), which can often escalate to pyelonephritis if they affect the kidneys. A urinalysis provides vital information by detecting the presence of nitrates, leukocyte esterase, bacteria, and white blood cells in the urine, all of which can indicate infection.

While other imaging tests like CT scans and X-rays can provide additional information about kidney structure or complications that might arise from pyelonephritis, they are not the initial tests used for diagnosis. Blood tests may be conducted to assess kidney function or to look for signs of systemic infection but are not specific for diagnosing pyelonephritis. Thus, for direct identification of the infection, urinalysis remains the most appropriate and effective choice.