[Importance of echography in the study of urinary tract infections in childhood]

One hundred and twenty-one children with a clinical diagnosis of urinary tract infection (UTI) were examined with sonography (US), ivp and voiding cystourethrography (VCUG). In 84 patients neither US nor radiographic findings were found of pathological significance; in 16 out of 37 patients with pathological findings both US and ivp were negative, whereas VCUG was decisive for a correct diagnosis. VCUG demonstrated vesicoureteric reflux in 10 patients, posterior urethral valves in 1 patient, and small diverticula of the urinary bladder in 5 patients. In 17 of the remaining 21 cases, there was agreement between US and urographic findings, whereas in 4 cases US provided us with false positives, with images of apparent renal scarring. The mistake was caused by an incorrect US detection of unilateral duplication of the collecting systems. The authors conclude by stressing the importance of ivp in the evaluation of urinary tract infections in children, even in case of negative VCUG and US results, and suggest comparing US measurements of renal length to the distance between three contiguous lumbar vertebrae in order to obtain measurements comparable to body growth.