title: The accuracy of renal point of care ultrasound to detect hydronephrosis in children with a urinary tract infection.
abstract: The objective of this study was to investigate the accuracy of renal point of care ultrasound (POCUS) for the detection of hydronephrosis in children with a urinary tract infection (UTI). We prospectively included all patients with a final diagnosis of UTI who visited our pediatric emergency department between November 2009 and April 2011. Emergency physicians were encouraged to perform a renal POCUS during these visits, and a follow-up renal ultrasonography was performed by a radiologist who was blinded to the results of POCUS. We calculated the accuracy of POCUS to detect hydronephrosis (renal pelvis enlargement ≥10 mm). We included 433 UTI visits, and 382 (88.2%) POCUS were performed. The sensitivity and the specificity were 76.5% (95% confidence interval: 58.1-94.6%) and 97.2% (95.2-99.2%), respectively. The positive and the negative predictive values were 59.1% (36.4-79.3%) and 98.8% (97.7-99.9%), respectively. Renal POCUS might be used to rule out hydronephrosis in pediatric UTI.
authors.affiliation: Departments of aPediatric Emergency bPediatric Radiology, Assistance Publique - Hôpitaux de Paris, Necker-Enfants Malades Hospital cMedical School, Paris Descartes University, Paris, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Guedj
authors.forename: Simon
authors.initials: S
authors.lastname: Escoda
authors.forename: Philippe
authors.initials: P
authors.lastname: Blakime
authors.forename: Géraldine
authors.initials: G
authors.lastname: Patteau
authors.forename: Francis
authors.initials: F
authors.lastname: Brunelle
authors.forename: Gérard
authors.initials: G
authors.lastname: Cheron
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005069:Evaluation Studies as Topic; D005260:Female; D005602:France; D006776:Hospitals, Pediatric; D006801:Humans; D006869:Hydronephrosis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008297:Male; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*