Renal ultrasound and excretory urography in infants and young children with urinary tract infection

Abstract
The main purpose of the study was to see whether excretory urography (EU) can be safely replaced by ultrasound (US) in children with urinary tract infection (UTI) younger than 6 years. 101 hospitalised children were admitted to the prospective study. They were all diagnosed as having UTI and were treated accordingly. All children had voiding cystography (VCU), EU and US done. US and EU correlated well in 94% of the cases. In all 6 cases with discrepancy between EU and US, the VCU was abnormal. Our results confirm the data from other authors, that VCU and US should be sufficient as an initial work-up on children with UTI, while EU should be done only in the cases with abnormal findings on either one or both of the former investigations. However, it should be kept in mind that some cases of parenchymal involvement or mild subpelvic stenosis can be missed using this protocol. If EU is obtained only in the cases with abnormal US and/or VCU, only 55 children (54%) in our group would have had an EU done.