Children with urinary tract infection; a critical diagnostic pathway

A protocol for the radiological investigation of children with urinary tract infection was introduced in a district general hospital in 1985. Every boy, and every girl under 5 years was investigated after one documented infection, and every girl over 5 years after two infections. Each child had an abdominal radiograph and a sonar scan of the urinary tract. Four years later the results were assessed by reviewing the radiology file or contacting the general practitioner of each of the first 200 children examined. Ten of 15 children diagnosed as not normal on screening and investigated further had an abnormality confirmed. Four of 25 children thought normal on screening had minor abnormalities shown on further examination. The results are assessed in the light of a review of recent literature and indicate that this screening protocol is efficient and effective.