Ultrasound and plain X-ray screening in childhood urinary tract infection

Area of Science:

• Pediatric Nephrology
• Diagnostic Imaging
• Urology

Background:

• Urinary tract infections (UTIs) are common in children.
• Diagnostic imaging is crucial for evaluating suspected UTIs.
• Invasive procedures like cystography and intravenous urography carry risks.

Purpose of the Study:

• To evaluate the diagnostic accuracy of ultrasound and plain X-ray for suspected UTIs in children.
• To determine if normal initial imaging can safely rule out significant urinary tract abnormalities.
• To assess the necessity of further invasive investigations based on initial imaging results.

Main Methods:

• A prospective study involving 309 children over 2 years old with suspected UTIs.
• Initial investigation included ultrasound and plain X-ray.
• Abnormal findings prompted further investigation with cystography and intravenous urography.

Main Results:

• Out of 309 children, 29 had abnormal findings on initial imaging.
• 10 of these cases had confirmed abnormalities via cystography and urography.
• In children with normal initial imaging (280), only 4 (out of 26 re-presenting) showed abnormalities on further testing.

Conclusions:

• Ultrasound and plain X-ray are reliable initial investigations for suspected UTIs in children.
• Normal findings on ultrasound and X-ray can help avoid unnecessary invasive procedures.
• This approach spares children from uncomfortable and potentially risky examinations.