title: Paediatric urinary tract infection and the necessity of complete urological imaging.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Urology, Paediatric Division, William Beaumont Hospital, Royal Oak, MI 48073, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Kass
authors.forename: K M
authors.initials: KM
authors.lastname: Kernen
authors.forename: J M
authors.initials: JM
authors.lastname: Carey
mesh_terms: D002985:Clinical Protocols; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014463:Ultrasonography; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging*; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid