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Updated: Jul 6, 2026
Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
Published on: June 21, 2024
Renal ultrasonography should be done routinely in children with first urinary tract infections
Hsin-Ping Huang1, Yi-Chun Lai, I-Jung Tsai
1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Insights
Renal ultrasonography (RUS) is valuable for children with a first febrile urinary tract infection. Abnormal RUS findings, like altered kidney size, correlate with a higher risk of vesicoureteral reflux.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Urology
Background:
- Febrile urinary tract infections (UTIs) are common in young children.
- Identifying renal scarring and structural abnormalities is crucial for guiding treatment and preventing long-term complications.
- Renal ultrasonography (RUS) is a primary imaging modality used in this population.
Purpose of the Study:
- To evaluate the diagnostic yield and clinical significance of RUS in children under 5 years old experiencing their first febrile UTI.
- To determine the association between specific RUS findings and the presence and grade of vesicoureteral reflux (VUR).
Main Methods:
- Retrospective analysis of imaging studies (RUS, CT, VCUG) in 390 children with a first febrile UTI.
- Exclusion of children with pre-existing urologic anomalies or other significant medical conditions.
- Correlation of RUS findings with VUR incidence and grade.
Main Results:
- 112 out of 390 children (28.7%) exhibited abnormal RUS findings.
- Abnormalities such as nephromegaly, small kidney, intermittent hydronephrosis, and double collecting systems were significantly associated with a higher incidence of VUR.
- High-grade VUR was more prevalent in children with abnormal RUS findings compared to those with normal scans.
Conclusions:
- RUS is a beneficial diagnostic tool in the initial workup of febrile UTIs in young children.
- Specific RUS findings, beyond isolated hydronephrosis, warrant further investigation due to their association with VUR.
- Abnormalities in kidney size or structure on RUS should prompt consideration for VUR evaluation.
Objectives:
To assess the consequences of renal ultrasonography (RUS) in the treatment of children younger than 5 years of age with a first febrile urinary tract infection.
Methods:
We retrospectively reviewed the results of imaging studies, including RUS, computed tomography, and voiding cystourethrography in children with a first febrile urinary tract infection during a 2-year period. Children with known urologic anomalies, other underlying diseases, or simultaneous combined illnesses were excluded. Children with nephromegaly were diagnosed with acute lobar nephronia by computed tomography.
Results:
A total of 390 children were included in this study. Of the 390 children, 112 (28.7%) had abnormal RUS findings. The children with abnormal RUS findings of nephromegaly, small kidney, intermittent hydronephrosis, or a double collecting system had a significantly greater incidence of vesicoureteral reflux than children with normal RUS findings. Additionally, the occurrence of high-grade vesicoureteral reflux in children with abnormal RUS findings was more frequent than in children with normal RUS findings.
Conclusions:
The results of our study indicate that it is worth performing RUS in children with a first febrile urinary tract infection because abnormal kidney size or other specific structural ultrasound findings should be investigated, in addition to isolated hydronephrosis.
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