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Ultrasonography for urinary tract evaluation in patients with congenital spine anomalies
S A Albanese1, A B Coren, M P Weinstein
1Department of Orthopedic Surgery, State University of New York, Health Science Center, Syracuse.
Insights
Pediatric patients with congenital spine anomalies often have urinary tract issues. Ultrasonography, alongside urinalysis and serum creatinine, is recommended for screening these children.
Area of Science:
- Pediatric Orthopedics
- Pediatric Urology
- Diagnostic Imaging
Background:
- Congenital spine anomalies can be associated with concurrent urinary tract abnormalities.
- Early identification of these co-occurring conditions is crucial for timely intervention and management.
- Retrospective review of pediatric orthopedic records is a common method for identifying patient cohorts with specific congenital conditions.
Purpose of the Study:
- To determine the incidence of urinary tract abnormalities in pediatric patients with congenital spine anomalies.
- To evaluate the effectiveness of different diagnostic modalities in identifying these urinary tract abnormalities.
- To establish an optimal screening protocol for urinary tract anomalies in this specific pediatric population.
Main Methods:
- Retrospective review of outpatient pediatric orthopedic records.
- Identification of patients with congenital spine and urinary tract anomalies.
- Intravenous pyelogram (IVP) followed by ultrasonographic evaluation for patients with positive IVP results.
- Comparison of IVP findings with ultrasonography results.
Main Results:
- Urinary tract abnormalities were identified in 26% (7 out of 27) of patients with documented IVPs.
- Seven patients underwent ultrasonographic evaluation, with results compared to their IVP findings.
- The study identified a significant association between congenital spine and urinary tract anomalies.
Conclusions:
- Ultrasonography, in conjunction with urinalysis and serum creatinine, is proposed as the preferred screening protocol.
- This combined approach offers a comprehensive method for detecting urinary tract abnormalities in pediatric patients with congenital spine anomalies.
- The findings support a proactive screening strategy to improve patient outcomes.
Abstract:
Outpatient pediatric orthopedic records were reviewed retrospectively in an attempt to identify all patients with congenital spine and urinary tract anomalies. All patients with a positive intravenous pyelogram (IVP) were asked to return for ultrasonographic evaluation. Urinary tract abnormalities were identified in seven (26%) of the 27 patients with documented IVPs. An additional patient was later added to the series, making a total of seven patients who returned for an ultrasonogram, which was then compared with the IVP. Observations and a review of the literature suggest that ultrasonography combined with urinalysis and serum creatinine is the screening protocol of choice in this patient population.