Paediatric urinary tract infection and the necessity of complete urological imaging

BJU Int. 2000 Jul;86(1):94-6. doi: 10.1046/j.1464-410x.2000.00728.x.


Objective: To evaluate voiding cysto-urethrography (VCUG) in assessing children with urinary tract infection (UTI) when renal/bladder ultrasonography and 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-ureteric 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 renal ultrasonogram. Twenty-three (23%) children with both a normal renal scan and renal/bladder ultrasonogram showed VUR on VCUG, of whom 14 had bilateral VUR and 13 grade III or higher VUR.

Conclusion: This study indicates that about 23% of patients may have significant VUR despite both a normal renal scan and ultrasonogram. Therefore, VCUG remains important in evaluating and managing children with UTI.

MeSH terms

  • Clinical Protocols
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Radiography
  • Radionuclide Imaging
  • Radiopharmaceuticals*
  • Technetium Tc 99m Dimercaptosuccinic Acid*
  • Ultrasonography
  • Urinary Tract Infections / diagnostic imaging*
  • Vesico-Ureteral Reflux / diagnostic imaging


  • Radiopharmaceuticals
  • Technetium Tc 99m Dimercaptosuccinic Acid