Paediatric urinary tract infection and the necessity of complete urological imaging

Objective To evaluate voiding cysto-urethrography (VCUG) in assessing child ren with urinary tract infection (UTI) when renal/bladder ultrasonography a nd renal scintigraphy show no abnormality. Patients and methods A total of 468 renal scintigrams taken in children for an indication of UTI between January 1996 and December 1998 were reviewed, The renal and bladder ultrasonograms of those children with a normal renal scan were then reviewed. Children with both normal renal scans and normal ultrasonography were then evaluated for the frequency and grade of vesico-u reteric reflux (VUR) on VCUG. Results Of the 468 patients, 453 (97%) had complete imaging studies: 152 of the children evaluated had normal renal scans, of whom 101 had a normal re nal ultrasonogram. Twenty-three (23%) children with both a normal renal sca n and renal/bladder ultrasonogram showed VUR on VCUG, of whom 14 had bilate ral VUR and 13 grade III or higher VUR. Conclusion This study indicates that about 23% of patients may have signifi cant VUR despite both a normal renal scan and ultrasonogram. Therefore, VCU G remains important in evaluating and managing children with UTI.