Does routine ultrasound have a role in the investigation of children with urinary tract infection?
The results of investigations in children with urinary tract infection (UTI) were studied in a district general hospital in order to assess the relative value of the two most widely used screening tests, namely ultrasound (US) and 99mTc dimercaptosuccinic acid (DMSA) scintigraphy. A total of 193 children had undergone both US and DMSA scintigraphy as part of an investigation of proven single or multiple urinary tract infections over a 27 month period. DMSA scintigraphy revealed abnormalities in 22 of the children (11%). The abnormalities ranged from cortical defects to congenital anatomical abnormalities. US revealed abnormalities in six children (3%) but did not contribute any additional information in any. In our institution, the DMSA scintigram alone would have been an adequate screening test for children with UTI. Hydronephrosis is a common abnormality detected by US. Although none were seen in the study group, several children were examined during the study period with dilated collecting systems detected at ante-natal US. No cases of hydronephrosis presented as UTI. We question whether the use of routine US is justifiable in the investigation of children with UTI, and discuss whether a more selective investigation protocol should be adopted.
Department of Diagnostic Radiology, West Cumberland Hospital, Whitehaven, Cumbria.
B
B
Mucci
B
B
Maguire
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D012008:Recurrence; D012189:Retrospective Studies; D004113:Succimer; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014463:Ultrasonography; D014551:Urinary Tract / Q000000981:diagnostic imaging; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging* / Q000209:etiology
D015609:Organotechnetium Compounds; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D004113:Succimer